RESUMO
@#<p style="text-align: justify;"><strong>OBJECTIVES:</strong> To report a benign tonsillar lesion presenting as a pedunculated polyp and discuss its diagnosis and management.<br /><strong>METHODS:</strong><br /><strong>Design:</strong> Case Report<br /><strong>Setting:</strong> Tertiary Government Hospital<br /><strong>Patient:</strong> One<br /><strong>RESULTS:</strong> A 14-year-old lad presented with a seven-year history of an elongated right tonsillar mass without associated bleeding, pain, dysphagia or obstructive sleep apnea. Physical examination revealed a pedunculated mass about 2 x 1 x 0.5cm in size located in the superior pole. After unilateral tonsillectomy, histopathological examination revealed lymphangectatic lipomatous fibrotic polyp.<br /><strong>CONCLUSION:</strong> Lymphangiomatous polyp of the palatine tonsils is an unusual benign lesion of the head and neck. These are commonly present as unilateral, polypoidal mass that cannot be clinically differentiated from other benign tonsillar lesions. Tonsillectomy is the recommended surgical approach for both diagnostic and therapeutic purposes. Histopathological study must be done to confirm diagnosis.</p>
Assuntos
Humanos , Masculino , Adolescente , Tonsila Palatina , Hamartoma , Tonsilectomia , Linfangioma , Transtornos de Deglutição , Pescoço , Cabeça , Apneia Obstrutiva do Sono , Pólipos , Dor , Exame FísicoRESUMO
Vascular ectasia is a well-known cause of lower gastrointestinal bleeding in the elderly. Endoscopically, it usually appears as a flat or elevated bright red lesion. We report on an extremely rare case of a large, pedunculated, polypoid vascular ectasia in an asymptomatic patient. A large pedunculated polypoid mass in the sigmoid colon was observed on colonoscopy during a regular health check-up, and a polypectomy was performed using a detachable snare. In histology, vessels with massive dilation were found mainly in the submucosa, which was consistent with vascular ectasia.
Assuntos
Idoso , Humanos , Colo Sigmoide , Colonoscopia , Dilatação Patológica , Hemorragia , Proteínas SNARERESUMO
BACKGROUND/AIMS: Immediate postpolypectomy bleeding (IPPB) increases the procedure time and it may disturb performing a safe polypectomy. The purpose of this study is to investigate whether clipping before snare polypectomy of large pedunculated polyps is useful for the prevention of IPPB. METHODS: This is a single arm, pilot study. We enrolled patients with pedunculated colorectal polyps that were 1 cm in size or more from 4 university hospitals between June 2009 and June 2010. Clips were applied at the stalk and snare polypectomy was then performed. The complications, including IPPB, were investigated. RESULTS: Fifty six pedunculated polyps in 47 patients (Male:Female=36:11; age, 56+/-11 years) were included. The size of the polyp heads was 17+/-8 mm. Tubular adenoma was most common (57%). The number of clips used before snare polypectomy was 2+/-0.5. The procedure was successful in all cases. IPPB occurred in 2 cases (3.6%), and both of these were managed by additional clipping. Delayed bleeding occurred in another one case (1.8%), which improved with conservative treatment. No perforation occurred. CONCLUSIONS: We suggest that clipping before snare polypectomy of pedunculated polyps may be an easy and effective technique for the prevention of IPPB, and this should be confirmed in large scale, prospective, controlled studies.
Assuntos
Humanos , Adenoma , Braço , Cabeça , Hemorragia , Hospitais Universitários , Respiração com Pressão Positiva Intermitente , Projetos Piloto , Pólipos , Proteínas SNARERESUMO
Gastric carcinoids usually appear as a single polypoid tumor or yellowish rounded submucosal tumor in the fundus or body of the stomach. Multiple gastric carcinoids are associated with pernicious anemia, chronic atrophic gastritis and Zollinger-Ellison syndrome. These are believed to be due to hypergastrinemia. In Korea, carcinoids usually appear as single round-based submucosal tumor or sessile polyps. Multiple pedunculated polypoid carcinoids were rarely reported. A 27-year old woman was admitted to our hospital due to melena. The endoscopy revealed multiple pedunculated polypoid lesions in the fundus and body, predominantly in Yamada type III and IV. The histopathologic examination revealed the diagnosis of gastric carcinoid tumors. Serum fasting gastrin level was normal. We report a case of multiple pedunculated polypoid gastric carcinoids without atrophic gastritis or hypergastrinemia with a review of relevant literatures.