Polyp-simulating mucosal prolapse syndrome in (pre-) diverticular disease

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Endoscopy

Background:

• Anal blood loss can be misdiagnosed.
• Conditions like malignancy, ulcerative colitis, and hemangioma may be mistaken for other rectal pathologies.
• Accurate diagnosis is crucial for appropriate patient management.

Purpose of the Study:

• To describe a specific type of polyp-simulating lesion found during endoscopy.
• To differentiate this condition from adenomatous polyps and other serious rectal diseases.
• To highlight the clinical significance of recognizing this syndrome for appropriate treatment.

Main Methods:

• Review of eight patients with anal blood loss and discrepant initial diagnoses.
• Endoscopic examination to characterize the nature of polypoid lesions.
• Clinical follow-up after dietary intervention.

Main Results:

• All patients presented with polyp-simulating lesions, not adenomatous polyps.
• Lesions consisted of hyperemic, prolapsing redundant mucosa in the sigmoid colon.
• Dietary modification resulted in lesion regression, though mucosal changes persisted.

Conclusions:

• The identified polyp-simulating mucosal prolapse syndrome is a distinct entity.
• Endoscopic polyp removal is not indicated for this condition.
• Recognition of this syndrome is vital to prevent unnecessary procedures and manage chronic rectal bleeding.