Limaiem F, Ben Slama S, Jedidi S, Aloui S, Lahmar A, Bouraoui S, Mzabi S
Department Of Pathology, Mongi Slim Hospital, Sidi Daoued La Marsa, Tunisia.
Pathologica. 2012 Aug;104(4):198-200.
Localized giant pseudopolyposis is a rare complication in inflammatory bowel disease defined as a pseudopolyp (isolated or clustered) larger than 1.5 cm in size. Giant pseudopolyps are more commonly found in ulcerative colitis compared to Crohn's disease and mainly involve the left colon. A 26-year-old male patient with a two-year history of Crohn's disease was admitted with increasing abdominal pain, vomiting, anorexia, weight loss and fever. On physical examination, the abdomen was diffusely tender. Computed tomography showed diffuse irregular thickening of the ileal wall and stenosis of the terminal ileum. The patient underwent ileo-cecal resection with re-anastomosis. The ileal portion of the resected specimen harboured multiple finger-like pedunculated polyps, with the smallest measuring 0.5 cm and the largest measuring 1.8 cm. Histologically, the polyps were consistent with granulation tissue. No evidence of dysplasia or malignancy was found. The post-operative course was uneventful considering one month follow-up. This report illustrates an unusual case of giant pseudopolyposis involving the ileum in a patient with Crohn's disease. The natural history of these lesions, as well as their optimal management, remain uncertain.
局限性巨大假息肉病是炎症性肠病中一种罕见的并发症，定义为大小超过1.5厘米的假息肉（孤立或成群）。与克罗恩病相比，巨大假息肉在溃疡性结肠炎中更常见，主要累及左半结肠。一名有两年克罗恩病病史的26岁男性患者因腹痛加剧、呕吐、厌食、体重减轻和发热入院。体格检查时，腹部有弥漫性压痛。计算机断层扫描显示回肠壁弥漫性不规则增厚以及末端回肠狭窄。该患者接受了回盲部切除并重新吻合术。切除标本的回肠部分有多个指状带蒂息肉，最小的为0.5厘米，最大的为1.8厘米。组织学上，息肉与肉芽组织一致。未发现发育异常或恶性肿瘤的证据。考虑到一个月的随访，术后过程顺利。本报告阐述了一例克罗恩病患者累及回肠的罕见巨大假息肉病病例。这些病变的自然病程及其最佳治疗方法仍不确定。
