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Case Reports
. 2018 May 9:5:e35.
doi: 10.14309/crj.2018.35. eCollection 2018.

Polypectomy for Recurrent Inflammatory Cap Polyposis Combined with Argon Plasma Coagulation

Soros Anuchapreeda  1 , Patduangpuk Phengsuthi  2 , Prapimphan Aumpansub  3 , Naruemon Wisedopas  4 , Thawee Ratanachuek  5
Affiliations
Case Reports

Polypectomy for Recurrent Inflammatory Cap Polyposis Combined with Argon Plasma Coagulation

Soros Anuchapreeda et al. ACG Case Rep J. .

Abstract

A 15-year-old adolescent boy presented with chronic constipation, difficulty in defecation, and episodic bloody stools. A rectal mass lesion was digitally palpated. Colonoscopy showed a large circumferential polypoid lesion of the mid-rectum. Snare polypectomy was performed, and histopathology confirmed a diagnosis of benign inflammatory cap polyposis. At 3-month follow-up, sigmoidoscopy showed multiple recurrences of polyps at the site of the previous rectal polypectomy, which were removed by combined hot snare polypectomy and argon plasma coagulation. At 1-year follow-up, the patient was symptom-free and had no more episodes of bloody stool. Follow-up sigmoidoscopy showed a post-polypectomy rectal mucosal scar without recurrent polypoid lesions.

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Figures

Figure 1
Figure 1
(A) Endoscopic colonoscopy showing a large polypoid lesion protruding into the entire lumen of the rectum. (B) Cap polyposis with characteristic surface blood vessels that are tortuous and dilated (white arrows).
Figure 2
Figure 2
Photomicroscopy showing a low-power light histopathology image of a benign polypoid colonic lesion with a fibrinous surface, or ‘cap,’ and surface ulceration, with superficial new vessels and mixed inflammatory cells. Hematoxylin and eosin (×100).
Figure 3
Figure 3
(A) Endoscopic colonoscopy showing a new polypoid lesion in the lower rectum with white exudate. (B) Endoscopic colonoscopy shows the appearance of the colonic mucosa following argon plasma coagulation of an area of cap polyposis presenting with small nodules.
Figure 4
Figure 4
Follow-up endoscopic colonoscopy shows a rectal scar (white arrows). No recurrent polyps are identified.
See this image and copyright information in PMC

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