Prolapsing mucosal fold: largest reported, presenting with major haemorrhage.

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Pathology

Background:

• Prolapsing mucosal folds are uncommon benign colonic lesions.
• Inflamed folds can mimic adenomatous or hyperplastic polyps.
• These lesions are typically small and asymptomatic.

Observation:

• A 55-year-old female presented with significant rectal bleeding.
• Colonoscopy revealed a large 45x12x5 mm pedunculated polyp in the sigmoid colon.
• No other colonic abnormalities like hemorrhoids, colitis, or diverticulosis were noted.

Findings:

• Histological examination confirmed a prolapsing mucosal fold.
• The polyp contained fibrovascular submucosal tissue with normal overlying mucosa.
• This represents the largest reported prolapsing mucosal fold in the literature.

Implications:

• Accurate differentiation of prolapsing mucosal folds from neoplastic polyps is crucial.
• Large prolapsing mucosal folds can present with significant symptoms like rectal bleeding.
• This case expands the known size spectrum of this benign colonic lesion.