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Cap Polyposis: An Elusive Diagnosis in a Pediatric Patient Successfully Managed With Endoscopic Treatment
Sanjeevani Tomar1, Martin Maksimak2, David L Diehl3
1Department of Internal Medicine, University at Buffalo, Buffalo, NY.
Insights
Cap polyposis, a rare rectal condition, involves inflammatory polyps with mucus. Endoscopic mucosal resection offers a viable treatment option when conservative medical management fails.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Cap polyposis is a rare condition affecting the rectum or sigmoid colon.
- It is characterized by inflammatory polyps coated in thick, fibrinopurulent mucus.
Observation:
- Patients typically present with mucoid diarrhea and rectal bleeding.
- Common treatments include antibiotics, steroids, infliximab, and aminosalicylates.
Findings:
- Conservative medical management may fail in some cases of cap polyposis.
- Endoscopic management, specifically wide-field endoscopic mucosal resection, is rarely reported but shown to be a viable option.
Implications:
- Wide-field endoscopic mucosal resection presents a minimally invasive alternative for refractory cap polyposis.
- This endoscopic approach may improve patient outcomes and reduce the need for surgical intervention.
Abstract:
Cap polyposis is a rare condition of the rectum or sigmoid colon manifested by inflammatory polyps covered by a thick layer of fibrinopurulent mucus. This condition typically presents as mucoid diarrhea and rectal bleeding, and patients are often prescribed antibiotics (such as those for Helicobacter pylori), steroids, infliximab, or aminosalicylates. Surgical management is an option for unresponsive disease, but endoscopic management has been rarely reported. For cases of cap polyposis in which conservative medical management fails, wide-field endoscopic mucosal resection is a viable option.
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