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Taniguchi A, Endo I, Nishiyama T, Watanabe N, Yoshida O, Asano H, Kubo M, Udaka T. Multiple enteric muco-submucosal elongated polyps causing intussusception. Clin J Gastroenterol 2024; 17:41-45. [PMID: 37976018 DOI: 10.1007/s12328-023-01888-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 10/24/2023] [Indexed: 11/19/2023]
Abstract
A 20-year-old woman presented to our hospital with abdominal pain. Abdominal computed tomography revealed multiple masses in the upper jejunum, which were suspected as lipomas. Partial resection of the small intestine, including the masses, was performed on the same day due to intussusception secondary to the masses. Pathological examination revealed that the masses consisted of mucosa and edematous submucosa with multiple dilated blood vessels and lymphatic ducts without muscularis propria. The masses were diagnosed as multiple muco-submucosal elongated polyps (MSEP), a type of non-neoplastic polyp. MSEP was originally named colonic MSEP, but with the development of endoscopic techniques and imaging tests, similar polyps have been reported to occur not only in the colon but also in the entire intestinal tract. In this case, multiple MSEPs in the upper jejunum caused intussusception. As reported cases of multiple lesions causing intussusception are few, our case may help to clarify the pathogenesis of this disease.
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Affiliation(s)
- Atsuki Taniguchi
- Department of Surgery, Mitoyo General Hospital, 809, Toyohama-cho Himehama, Kanonji-shi, Kagawa, 769-1695, Japan.
| | - Izuru Endo
- Department of Surgery, Mitoyo General Hospital, 809, Toyohama-cho Himehama, Kanonji-shi, Kagawa, 769-1695, Japan
| | - Takeyoshi Nishiyama
- Department of Surgery, Mitoyo General Hospital, 809, Toyohama-cho Himehama, Kanonji-shi, Kagawa, 769-1695, Japan
| | - Nobuyuki Watanabe
- Department of Surgery, Mitoyo General Hospital, 809, Toyohama-cho Himehama, Kanonji-shi, Kagawa, 769-1695, Japan
| | - Osamu Yoshida
- Department of Surgery, Mitoyo General Hospital, 809, Toyohama-cho Himehama, Kanonji-shi, Kagawa, 769-1695, Japan
| | - Hiroaki Asano
- Department of Surgery, Mitoyo General Hospital, 809, Toyohama-cho Himehama, Kanonji-shi, Kagawa, 769-1695, Japan
| | - Masatoshi Kubo
- Department of Surgery, Mitoyo General Hospital, 809, Toyohama-cho Himehama, Kanonji-shi, Kagawa, 769-1695, Japan
| | - Tetsunobu Udaka
- Department of Surgery, Mitoyo General Hospital, 809, Toyohama-cho Himehama, Kanonji-shi, Kagawa, 769-1695, Japan
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Pan P, Zhang G, Cui X, Liu L. Duodenal Worm-Like Polyp. Dig Dis Sci 2023; 68:4275-4276. [PMID: 37775623 DOI: 10.1007/s10620-023-08113-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 09/12/2023] [Indexed: 10/01/2023]
Affiliation(s)
- Pan Pan
- Department of Pathology, Jinan Central Hospital, 105 Jiefang Road, Lixia District, Jinan, 250011, Shandong, China
| | - Guoshan Zhang
- Department of Gastroenterology, Jinan Central Hospital, 105 Jiefang Road, Lixia District, Jinan, 250011, Shandong, China
| | - Xiao Cui
- Department of Gastroenterology, Jinan Central Hospital, 105 Jiefang Road, Lixia District, Jinan, 250011, Shandong, China
| | - Liang Liu
- Department of Gastroenterology, Jinan Central Hospital, 105 Jiefang Road, Lixia District, Jinan, 250011, Shandong, China.
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Kikuchi R, Emoto S, Nozawa H, Sasaki K, Murono K, Abe S, Sonoda H, Shinozaki-Ushiku A, Ishihara S. Jejunal intussusception and perforation due to enteric muco-submucosal elongated polyp: a case report and literature review. Surg Case Rep 2023; 9:4. [PMID: 36627469 PMCID: PMC9832183 DOI: 10.1186/s40792-022-01584-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 12/28/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND A muco-submucosal elongated polyp is a non-neoplastic growth composed of mucosa and submucosa. Although muco-submucosal elongated polyps are commonly reported in the large intestine, they are rare in the small intestine, in which they are called enteric muco-submucosal elongated polyps. We herein present a case of jejunal intussusception and perforation due to an enteric muco-submucosal elongated polyp. CASE PRESENTATION A 46-year-old woman presented with abdominal pain and vomiting. Computed tomography revealed jejunal intussusception, which was reduced via a nasointestinal ileus tube. Oral double-balloon endoscopy showed an elongated polyp in the proximal jejunum. The patient refused surgical resection and thus, the polyp was monitored. Six months later, the patient was readmitted with the recurrence of jejunal intussusception and underwent emergency surgery. Intraoperative findings revealed an intussuscepted bowel with an elongated polyp and multiple perforations in the proximal jejunum. We resected approximately 90 cm of the bowel, including the intussuscepted segment and perforated sites. The pedunculated polyp, which was 60 mm in length, was located on the oral side of the resected specimen. Histopathologically, the polyp was covered by normal mucosa and the submucosa consisted of edematous loose connective tissue. The histopathological diagnosis confirmed an enteric muco-submucosal elongated polyp. CONCLUSIONS Symptomatic patients with enteric muco-submucosal elongated polyps may be at risk of complications, as observed in the present case, and need to undergo timely resection.
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Affiliation(s)
- Ryosuke Kikuchi
- grid.412708.80000 0004 1764 7572Department of Surgical Oncology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655 Japan
| | - Shigenobu Emoto
- grid.412708.80000 0004 1764 7572Department of Surgical Oncology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655 Japan
| | - Hiroaki Nozawa
- grid.412708.80000 0004 1764 7572Department of Surgical Oncology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655 Japan
| | - Kazuhito Sasaki
- grid.412708.80000 0004 1764 7572Department of Surgical Oncology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655 Japan
| | - Koji Murono
- grid.412708.80000 0004 1764 7572Department of Surgical Oncology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655 Japan
| | - Shinya Abe
- grid.412708.80000 0004 1764 7572Department of Surgical Oncology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655 Japan
| | - Hirofumi Sonoda
- grid.412708.80000 0004 1764 7572Department of Surgical Oncology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655 Japan
| | - Aya Shinozaki-Ushiku
- grid.412708.80000 0004 1764 7572Department of Pathology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655 Japan
| | - Soichiro Ishihara
- grid.412708.80000 0004 1764 7572Department of Surgical Oncology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655 Japan
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Colonic Mucosubmucosal Elongated Polyp in the Sigmoid Colon on Surveillance Colonoscopy. ACG Case Rep J 2019; 6:e00110. [PMID: 31616775 PMCID: PMC6722346 DOI: 10.14309/crj.0000000000000110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/03/2019] [Indexed: 11/17/2022] Open
Abstract
Colonic mucosubmucosal elongated polyp (CMSEP) is a newly designated colorectal polyp. It has unique endoscopic features of a worm- or drumstick-shaped appearance. Histologically, it is composed of normal colonic mucosa and expanded submucosa with a prominent vascular component and no significant inflammation. CMSEP is usually detected incidentally on screening colonoscopy or colonoscopy for other causes. Differential diagnoses that need to be considered include mucosal prolapse syndrome, filiform polyposis, hamartomatous polyp, colon leiomyoma, inverted diverticulum, and residual stalk of a pedunculated adenoma. We present a case of CMSEP on surveillance colonoscopy and literature review.
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