Colonoscopy with indigocarmine chromoendoscopy

Description:

This is the case of a 70-year-old woman who has a history of multiple colonic polypectomies. The history of the resection specimen had revealed hyperplastic polyps and serrated adenomas. Altogether, this patient fulfills the diagnostic criteria of having a hyperplastic polyposis syndrome. This syndrome is associated with a significantly increased risk of colonic carcinomas, and, therefore, complete detection and resection of lesions at surveillance colonoscopy is mandatory.
Here, colonoscopy with indigocarmine chromoendoscopy is performed to detect serrated lesions in the right hemicolon. A complicated lesion at the appendiceal orifice is resected.

Take home messages:

Hyperplastic polyposis is a syndrome that is associated with an increaesed risk of colorectal cancer.

The typical findings are multiple flat serrated lesions with predominance in the right colon.

In the hyperplastic polyposis syndrome we find both: true hyperplastic polyps as well as serrated adenomas.

Chromoendoscopy with indigocarmine is helpful to identify and demarcate the lesions that do mostly have a flat phenotype.

Resection of all lesions larger than 5 mm is strongly recommended.

 

Author:

Presented by: Gerhard Mayer, HSK Dr. Horst-Schmidt-Kliniken Wiesbaden, Germany; Hironori Yamamoto, Jichi Medical School, Kawachi, Japan; Pradeep Bhandari, Queen Alexandra Hospital Cosham, Great Britain

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