The Journal of the American Osteopathic Association, 2020/02, 120(2):121. doi: 10.7556/jaoa.2020.024, type of study: ,ci,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Free full text   (https://www.degruyter.com/document/doi/10.7556/jaoa.2020.024/html)

Keywords:

rectal bleeding [1]
rectal polyp [1]
clinical images [12]

Abstract:

A 45-year-old woman presented to the clinic with hematochezia. She described 2 years of intermittent, painless, small-volume rectal bleeding after bowel movements, without weight loss or constipation. She had no family history of colon cancer. A colonoscopy revealed a large rectal polyp (image A) with gyrus-like pits, which were well visualized with narrow-band imaging (image B). Endoscopic ultrasonography demonstrated no submucosal invasion. A polypectomy was performed piecemeal via endoscopic mucosal resection using an injectable liquid compound (SIC-8000) for submucosal lift. Histologic analysis confirmed a tubulovillous adenoma, 4.8 cm in the greatest dimension. The hematochezia resolved following polypectomy. Colon polyps account for nearly 13% of rectal bleeding in outpatients.1 A tubulogyrus surface pattern of polyps suggests adenomatous histology.2 When found, adenomas should be resected because of the risk of malignant transformation. SIC-8000 is a Food and Drug Administration-approved agent for submucosal injection during endoscopic mucosal resection and is a safe and potentially more effective alternative to saline.3