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Lecture notes

colorectal-polyps

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Lecture notes of 8 pages for the course General Surgery 2 at CAM (.)

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  • March 30, 2016
  • 8
  • 2015/2016
  • Lecture notes
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DRzaiter
Colorectal Polyps
Definition of a polyp
A lesion which projects into the lumen of the bowel, The term is morphological, and for
an actual diagnosis to be made, histology is needed.



Description
-Size of a few mm to several cm in diameter.

-Single or multiple. In polyposis syndrome hundreds may be found

-Larger polyps are found in the rectum

-5% may contain invasive carcinoma at discovery.

-The type of cell that forms the polyp varies and is important in determining its potential
for developing into a cancer



Epidemiology
Highly prevalent in the population, especially among older population (up to 50% over
60s have an adenomatouspolyp).



Risk factors:
-Over 50’s

-If there is a personal history of polyps

-If there is a family historyof polyps or colon cancer

-Smoker

-Drinker

-Overweight/fatty food intake?

-Differences in dietary fibre and antioxidants/calcium/folate?

-Differences in race and sex are less prominent
1

, Clinical presentation
-Most polyps are asymptomatic until they grow to 2cmin diameter

-They can lead to bleeding, frank blood or microscopic bleeding (presenting with anemia)

-Polyps rarely present with a change in bowel habit –but large polyps in the rectum can
present with tenesmus.

-A large amount of mucuscan also be passed.

-Rarely a polyp will prolapse through the anus or act as an apex for an intussception.



Complications
1-Lower GI Hemorrhage

2-Oclusions

3-Malignancy



Diagnostic tools
1. Colonoscopy + biopsy

2. Barium enema and X-ray

3. Sigmoidoscopy

4. Rigid proctoscopy–for rectal polyps

5. CT Colonography




2

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