Colonic Polyps

Introduction

There are 3 types of benign polyps (hamartomas) hyperplastic polyp most common type in adults often rectosigmoid sawtoothed appearance does NOT predispose to malignancy juvenile polyps most common type in children often rectosigmoid Peutz-Jeghers polyposis There are 3 types of neoplastic polyps (adenomas) tubular adenoma most common polyp usually pedunculated (stalked) tubulovillous adenoma usually pedunculated (stalked) villous adenoma greatest malignant potential  usually sessile may secrete protein and K+-rich mucus may involve Familial Adenomatous Polyposis

Presentation

Sympoms rectal bleeding polyp prolapse from rectum

Evaluation

Sigmoidoscopy / colonoscopy Labs villous adenoma may show hypokalemia and hypoalbuminemia

Differential

Polyposis syndromes Juvenile polyposis AD inheritance multiple juvenile polyps in GI tract ↑ risk of adenocarcinoma Cronkhite-Canada syndrome  consists of juvenile polyposis with fingernail dystrophy

Prognosis, Prevention, and Complications

Malignancy risk ↑ by ↑ size ↑ villous histology villous = villainous ↑ epithelial dysplasia

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