See other cases
The two towers
History :
A 48-year-old patient with a positive fecal occult blood test (FOBT) was referred for colonoscopy as part of the screening program.
Clinical & biological :
No symptoms.
Imaging :
Two pedunculated polyps (Paris Ips) were visualised in the sigmoid with iSCAN 1,2 aspect and OE (optical enhancement) revealing a gtyrus-like pattern (J-NET2A / Kudo IIIL) (Figure 1-2, Video 1). At the base of the polyps edema is observed (chicken skin appearance) due to traction in the colonic mucosa.
Polyps were resected by endoscopic polypectomy after injection of 5 mL 1:10 000 epinephrine diluted in Gelofusine + methylene blue (MB), without complications (Figure 3-4, Video 2). Two hemostatic clips were placed at the end of the procedure (Figure 5-6, Video 3).
Diagnostic :
Tubular adenomas with low dysplasia.
Discussion :
Rare case of polyps located in the proximal colon.
Conclusion :
The detailed examination allows to establish the correct polypectomy technique.
References :
1. Bianchi M, Clemente V, Koch M. The “Siamese twins” polyps. Dig Liver Dis 2015; 47(4): 346.
2. Benatta MA, Desjeux A, Grimaudb JC. A double-headed polyp. Ann Gastroenterol 2013; 26(1): 72.
3. Olson MR, Govil YK. Two polyps on a common stalk. Gastrointest Endosc 2011; 74(3): 692.
