The management of gastric polyps.

Gastric polyps are rare. Most patients either are asymptomatic or present with symptoms of vague epigastric pain and bloating. An upper gastrointestinal tract study can demonstrate gastric polyps in 85 to 90 per cent of the patients. Features that increase the suspicion of carcinoma include the presence of adenomatous polyps greater than 2 centimeters in diameter, especially if they are multiple. In most patients, gastrotomy and removal of the polypoid mass with a cuff of normal mucosa are sufficient treatment. In patients who have invasive adenocarcinoma found upon biopsy of the polyp, gastric resection should be done. In most patients with carcinoma in situ, wedge resection is adequate treatment. Endoscopy for the diagnosis and treatment of polyps is appropriate in selected patients with pedunculated polyps that are less than 2 centimeters in diameter. The morbidity after operation or endoscopy is similar. Patients who are at high risk of having carcinoma develop should be observed yearly by endoscopic examination and biopsy.