Adult juvenile polyp bleeding detected by extravascular contrast leakage and treated with endoscopic clipping:A case report  

作　　者：Fumiya Kataoka Takayuki Nakanishi Hiroshi Araki Shoichi Ichino Makoto Kamei Hiroyuki Makino Ryotaro Nagao Takayuki Asano Atsushi Tagami Hisataka Moriwaki 

机构地区：[1]Department of Gastroenterology,Matsunami General Hospital,Hashima 501-6062,Gifu,Japan

出　　处：《World Journal of Gastrointestinal Endoscopy》2025年第2期65-71,共7页世界胃肠内镜杂志(英文)

摘　　要：BACKGROUND Juvenile polyps(JPs)are non-neoplastic polyps.In adults,JPs present with hematochezia in only approximately half the patients and are often found incidentally during endoscopic screening.JPs have no mucosal fascia at the tip,and spontaneous shedding and massive gastrointestinal hemorrhage may occur.Thus,the JP bleeding detected in this case by extravascular contrast leakage on computed tomography scans and treated with endoscopic clipping is rare.CASE SUMMARY A previously healthy 31-year-old male patient presented with a 2-day history of bloody stools.Upon hospital arrival,rectal examination revealed fresh blood,and abdominal computed tomography scans showed extravascular contrast leakage from the lower rectum’s left-side wall.His blood pressure was slightly low at 104/62 mmHg.However,his pulse rate(69 bpm)and oxygen level(99%on room air)were within normal limits.Emergency endoscopy revealed a pedunculated lesion in the rectum covered by a non-neoplastic mucosal epithelium.No neoplastic lesions were observed at the tip of the polyp;however,pulsatile bleeding was detected at the distal end.We performed endoscopic hemostasis by clipping the stem and then performed a polypectomy above the stem to examine the lesion tissue.Histopathological evaluation revealed a cystically dilated gland without neoplastic lesions.A subsequent total colonoscopy revealed two JPs with characteristic edematous,smooth,and reddish surfaces close to the hemorrhagic lesion.Subsequent histopathological evaluation indicated findings characteristic of JP,such as severe inflammatory cell infiltration of the stroma and cystic dilatation of the glandular ducts.CONCLUSION There are no reports of adult JPs presenting with contrast extravasation where endoscopic hemostasis was successful,as in this case.

关 键 词：Contrast-enhanced computed tomography Endoscopic clipping Juvenile polyp Rectal bleeding Contrast extravasation Case report 

分 类 号：R575[医药卫生—消化系统]