Résumé
Inflammatory pseudopolyps associated with inflammatory bowel disease occur on inflamed colon mucosa due to the regeneration and healing of ulcerated epithelium. They are classified as giant when they are over 1.5-cm in diameter. These are a rare, benign complication, but can be similar in appearance to colorectal cancer. It has been reported that they do not usually regress after medical treatment, requiring endoscopic resection or even surgery. In this paper, we report an unusual case with gradual regression of giant pseudopolyps with medical treatment, in a patient with inflammatory bowel disease, and another very uncommon case of a giant pseudopolyp in indeterminate colitis, with obstruction requiring surgery, as it was not possible to rule out carcinoma. A multidisciplinary team is very important.
Résumé
Crohn's disease was originally described as a small bowel disorder and has been known to involve the large bowel in approximately 40% of all cases with or without concomitant ileal component. We describe two cases of Crohn's diseas of small intestine and colon with a summary of differential diagnosis with ulcerative colitis. Both cases were originally diagnosed and treated as ileal tuberculosis. Grossly, there were skip lesions in both cases with prominent pseudopolyps and ulcerations in colon. Also noted were typical serpentine lesions in ileum as well as in colon. Microscopically, transmural inflammation was confirmed and one case showed scattered noncaseating granulomas in the wall. Submucosal edema and fibrosis with thickening of the wall was not prominent in colon. Polymerase chain reaction performed on paraffin block for the demonstration of Mycobacterium tuberculosis in one case showed negative reaction.