Wednesday, March 4, 2015

Colon Polyps
WHO Classification of Colon Polyps

 The term “ polyp ” describes a mass of tissue sticking out into the lumen of the internal organ, while not implying pathological connection. Polyps are often pedunculate, round, or sessile and may alter in length. They can occur as solitary or multiple polyps. Polypoid lesions are the most common pathological finding of colonoscopy or endoscopy procedure. With the help of histological examination polyps can be classified. Pathologically and anatomically, polyps of epithelium are distinguished from those of germ layer tissue and there are also many different special forms.
Table shows the World Health Organization classification of large intestine polyps. in keeping with World Health Organization guidelines, epithelial polyps are divided into neoplastic and nonneoplastic (tumorlike) polyps, whereby growth polyps compose some 70% of all colorectal polyps .

Diagnosis of Colon Polyps
  • Case history or Family History
  • Clinical Examination (rectal digital examination)
  • Occult Bloodtest
  • Total Endoscopy
  • Double Contrast Barium Enema
  • Virtual Colonoscopy

Family history and clinical findings form the idea for diagnosis. case history is particularly necessary for hereditary styles of polyposis syndrome and wherever there\'s a family history of large intestine adenomas and carcinomas. Digital rectal examination makes a very important contribution to clinical findings, however it solely detects only around 5–10% of polyps. Occult blood tests don\'t seem to be suitable as a primary screening tool for adenomas, as their sensitivity for adenomas is just half-hour. Occult blood tests are negative for ninety three of colon adenomas up to one cm in size and for seventy seven of adenomas 1–2 cm in size, whereby seven-membered of polyps of this size are malignant. fourth part of polyps larger than two cm escape detection and of these up to 45th are already transforming malignantly.

Importance of Endoscopy

Problem of forceps biopsy for polyps
Endoscopy, like total colonoscopy, is important and it is the most diagnostic tool. endoscopy is that the most informative methodology of diagnosis of colon polyps. endoscopic biopsy or ectomy, of polyps at first includes a strictly diagnostic role. Not until the results of histologic analysis are available will it be determined whether or not scrutiny is the definitive treatment method or whether or not other treatments (removal of remaining polyp pieces, surgical intervention) are needed. Early-stage polyps are often detected and removed endoscopically, thereby reducing the incidence of malignant neoplastic disease.

Complementary Procedures.

Barium Enema are often used complementarily, e.g., for strictures, endoscopically impassable segments, or in cases wherever endoscopy isn\'t possible. contrast enemas ought to only be administered using double-contrast technique; false negative findings occur in 2–22% of patients mistreatment using, looking on size. The role of virtual colonoscopy in diagnosis colon polyps remains unclear. Virtual colonoscopy will, however, hardly replace typical colonoscopy as a screening tool: sensitivity for adenomas 5mm is around 30–50%; for adenomas 6–9 millimeter, sensitivity is at the foremost eightieth and for adenomas 1 cm ca. 90%. in additional recent studies, results of virtual colonoscopy square measure even less impressive: the speed of detection of polyps 1 cm is according at seventieth and among polyps 5–9mm at only 40–60%. Thus, for polyps detected by virtual colonoscopy, standard colonoscopy is totally essential for ectomy of the polyp; presently two hundredth of detections are false positives.

Colon Polyps Symptoms

 Most polyps don\'t cause any symptoms. potential symptoms include anal hemorrhage (unexplained iron deficiency anemia) and signs of obstruction in the middle of abdominal pain (larger polyps). Villous adenomas have a special status associated with their clinical image as they can secrete a watery potassium-rich secretion, sometimes up to many liters per day. The patient therefore suffers from watery looseness of the bowels and mucous discharge; laboratory tests might observe hypokalemia.

Types of Colon Polyps

There are various type of colonic polyps according to WHO epithelial polyps are devided into neoplastic and non neoplastic polyps here are the type of colon polyps:

 Type of Neoplastic Polyps:
  1. Adenoma
  2. Polypoid carcinoma
  3. Carcinoid tumor
  4. Nonepithelial tumors (lipoma, leiomyoma, hemangioma,lymphangioma, etc.)

Type of Non neoplastic Polyps
  1. Inflammatory polyp
  2. Benign lymphoid polyp
  3. Peutz–Jeghers polyp
  4. Juvenile polyp
  5. Hyperplastic polyp

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