Ekr

Sigmoid Colon Polyp

c a b a-c Multiple diminutive polyps, Gardner syndrome.

a b a-c Multiple diminutive polyps, Gardner syndrome.

Sigmoid Colon Polyp

d Improved detection of diminutive polyps using chromoendoscopy, Gardner syndrome.

Peutz Jeghers Syndrome

Fig. 9.7 Stalked polyp, Peutz-Jeghers syndrome, lobular with infarction.

Fig. 9.7 Stalked polyp, Peutz-Jeghers syndrome, lobular with infarction.

Given the risk of malignant transformation, treatment consists of a colectomy-proctomucosectomy with ileoanal anastomosis and pouch. Genetic counseling and evaluation, and, if indicated, screening tests, should be conducted on affected individuals during childhood.

Peutz-Jeghers Syndrome

Polyps related to Peutz-Jeghers syndrome are ha-martomatous with a characteristic histological appearance of tree branchlike muscularis mucosae. They can vary in size (up to a few centimeters), be stalked or sessile, irregular, or lobular. The surface may show signs of infarction (Fig. 9.7).

If possible, polyps should be removed when symptoms manifest themselves. Asymptomatic polyps should also be endoscopi-cally resected, even though they generally do not transform malignantly. Surgical intervention is only justified in the case of bleeding or stenosis.

- [F| 9.13 Juvenile polyposis

- [F| 9.13 Juvenile polyposis

a Smooth surface of a juvenile polyp with known polyposis syndrome. b Diminutive polyps in the terminal ileum, juvenile polyposis.

Peutz Jeghers Syndrome

c, d Juvenile polyposis with stalked polyps and tiny polyps.

a Smooth surface of a juvenile polyp with known polyposis syndrome. b Diminutive polyps in the terminal ileum, juvenile polyposis.

c, d Juvenile polyposis with stalked polyps and tiny polyps.

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