Clinical Image
A 30-year-old woman presented with 6-month history of blood-stained stools. The patient denied a family history of colon cancer. Examination was remarkable for blood-streaked stool. A colonoscopy identified a reddish and pedunculated polyp with long stalks in the descending colon measuring 10 × 20 mm macroscopically (Figure 1A), which was well-defined by narrow-band imaging (NBI) magnifying endoscopy (Figure 1B). The solitary bleeding polyp was removed by hot snare polypectomy. Microscopic examination of the specimen demonstrated colonic mucosa with dilated and branched mucin-filled crypts surrounded by stroma containing mixed inflammatory cells (Figure 1C), which was consistent with juvenile polyp. Upper gastrointestinal endoscopy and double-balloon enteroscopy found no polyps in the stomach, duodenum, jejunum and ileum. He had no family history of juvenile polyposis syndrome. A solitary colonic juvenile polyp complicated with bleeding is rare [1]. Because of the potential risk of bleeding, obstruction, and intussusception complicated by giant juvenile polyp, endoscopic resection is recommended.
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Figure 1. A. A colonoscopy identified a reddish and pedunculated polyp with long stalks in the descending colon, measuring 10 × 20 mm macroscopically. B. Narrow-band imaging magnifying endoscopy review. C. Microscopic examination of the specimen demonstrated colonic mucosa with dilated and branched mucin-filled crypts surrounded by stroma containing mixed inflammatory cells.
Conflicts of Interest
The authors have no conflicts of interest to declare.
Ethical Statement
The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Written informed consent was obtained from the patient for publication of this “GI Image”. Board institutional approval was not required.
Author’s Contributions
Collection of data and writing: Yun-Ping Sun.
Manuscript preparation: Yun-Ping Sun.
Final approval of the manuscript: Wei Liu.