Adenomatosis coli 1
This 37-year-old white male patient was referred for colonoscopy after noticing blood in his stool. There was no relevant prior history of serious disease and the family history was unremarkable.
The videoclip begins in the cecum and shows short passages as the instrument is withdrawn through the ascending colon and the sigmoid colon. In all segments of the colon there are numerous polyps up to 1.5 cm in diameter characterized by a lobular surface. They are somewhat darker in color than the surrounding colonic mucosa and only a few have pedicles. Vascular structures are well visualized between the polyps. The tissue did not show increased vulnerability.
Several polyps were removed by wire cautery. Histological examination revealed tubular adenomas without evidence of high-grade dysplasia.
Both endoscopic and histologic findings are consistent with adenomatosis coli. The papilla was endoscopically normal. There were no polyps in the small bowel. Both the father and one brother underwent colonoscopy; in both cases, colonoscopic findings were normal. It is probable that this patient was suffering from a sporadic case of polyposis coli.
At age 37 years, the diagnosis was made very late. The patient was advised to undergo proctocolectomy and it was further recommended to examine his two children, who were aged 13 and 16 years at the time of diagnosis.