Fumimoto Yuichi, Tamagawa Koji, Ito Toshinori, Sawa Yoshiki, Nishida Toshirou
Department of Surgery (E1), Osaka University Graduate School of Medicine, Suita, Japan.
Case Rep Gastroenterol. 2008 Apr 10;2(1):128-33. doi: 10.1159/000122588.
Although inflammatory polyposis is one of the common complications in patients with inflammatory bowel disease, it is rare that each poly grows up to more than 1.5 cm. We describe a case of localized giant inflammatory polyposis of the ileocecum associated with Crohn's disease. A 40-year-old man who had been followed for 28 years because of Crohn's disease was hospitalized for right lower abdominal pain after meals. Barium enema and colonoscopy showed numerous worm-like polyps in the ascending colon which grew up to the hepatic flexure of the colon from the ileocecum, causing an obstruction of the ileocecal orifice. Since histology of a biopsy specimen taken from the giant polyps showed no dysplasia, he was diagnosed with ileus due to the localized giant inflammatory polyposis. A laparoscopically assisted ileocecal resection was performed. The resected specimen showed that the giant polyps grew up into the ileocecum. Histological examination revealed inflammatory polyposis without neoplasm. Generally, conservative treatment is indicated for localized giant inflammatory polyposis because this lesion is regarded as benign. However, occasionally serious complications arise, requiring surgical treatment.
尽管炎性息肉病是炎症性肠病患者常见的并发症之一，但每个息肉长到超过1.5厘米的情况却很少见。我们报告一例与克罗恩病相关的回盲部局限性巨大炎性息肉病病例。一名因克罗恩病接受了28年随访的40岁男性，因餐后右下腹痛入院。钡剂灌肠和结肠镜检查显示升结肠有大量蠕虫样息肉，从回盲部延伸至结肠肝曲，导致回盲瓣口梗阻。由于从巨大息肉上取下的活检标本组织学检查未发现发育异常，他被诊断为局限性巨大炎性息肉病所致肠梗阻。遂行腹腔镜辅助回盲部切除术。切除标本显示巨大息肉已长入回盲部。组织学检查显示为炎性息肉病，无肿瘤形成。一般来说，局限性巨大炎性息肉病通常采取保守治疗，因为该病变被视为良性。然而，偶尔会出现严重并发症，需要手术治疗。
