Topical budesonide for treating giant rectal pseudopolyposis

First Department of Internal Medicine, Sismanogleion Hospital, Athens, Greece.
Anticancer research (Impact Factor: 1.83). 07/2005; 25(4):2961-4.
Source: PubMed


Pseudopolyps are a frequent finding in the course of inflammatory bowel disease. They are non-neoplastic lesions resulting from a regenerative and healing process that leaves inflamed colonic mucosa in polypoid configuration. Data about their management is lacking. "Giant" pseudopolyps can be mistaken for adenocarcinomas and, as they rarely regress with medical management alone, a surgical resection is often required. A case ofgiantpseudopolyposis treated non-surgically, in a patient with concomitant ulcerative colitis and chronic hepatitis B, is reported, representing a co-morbidity complicating an eventual conservative treatment. The clinical implementation of topical budesonide was originally tested, resulting in clinical, endoscopic and histological remission. Budesonide seems a promising therapy for IBD, particularly when a comorbidity with viral hepatitis exist.

Download full-text


Available from: Maria Demonakou, Jul 11, 2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: Post-inflammatory polyps >15 mm in diameter or length are termed "giant". This benign and rare sequel of ulcerative colitis or colonic Crohn's disease can mimic colorectal carcinoma. To illustrate this rare complication of inflammatory bowel disease and outline the characteristic radiological, endoscopic and histopathological features, by reviewing all previously published cases of giant post-inflammatory polyps in the English literature. Reports of 81 giant post-inflammatory polyps in 78 patients were identified by systematic review of the literature. The incidence of giant post-inflammatory polyps is related to the extent of ulcerative colitis (incidence: 0%, 30%, and 70%, in proctitis, left-sided, and extensive disease, respectively). These lesions are typically located in the transverse or descending colon. Giant post-inflammatory polyps are as common in Crohn's disease (n=36) as in ulcerative colitis (n=42, 54%). Clinical presentations varies, including pain (n=29), rectal bleeding (n=20), diarrhoea (n=19), luminal obstruction (n=15), or a palpable mass (n=11). Symptomatic presentation results in surgical resection. Clinical details and outcomes are comprehensively tabulated. Recognition of this rare entity will prevent unnecessary radical surgical resection for presumed carcinoma. It highlights the need for clinical, radiological, endoscopic and histopathological correlation.
    Journal of Crohn s and Colitis 06/2008; 2(2):170-80. DOI:10.1016/j.crohns.2007.10.007 · 6.23 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Localized giant pseudopolyposis of the colon (pseudopolyp larger than 1.5 cm in size) is a rare complication of inflammatory bowel disease. There is one report of an occult carcinoma within such a lesion, and no reports of sole dysplasia. A case of a 42-year-old man with longstanding Crohn's colitis who underwent a colonoscopy revealing a large, multilobulated mass at the splenic flexure that was not amenable to endoscopic removal, is described. Multiple biopsies showed no dysplasia and histology was consistent with an inflammatory pseudopolyp. Computed tomographic colonography demonstrated a mass resembling a large villous tumour. A decision for surgery was made. The surgical specimen was a complex anastomosing inflammatory pseudopolyp 5 cm x 4 cm x 3 cm in size, with a focus of low-grade dysplasia in an area free of inflammation. The present case is the first reported occult dysplasia in a giant pseudopolyp. Occult dysplasia without superficial dysplasia may exist in these lesions and further studies are needed to examine risk factors that make a giant pseudopolyp more likely to harbour dysplasia and/or carcinoma.
    Canadian journal of gastroenterology = Journal canadien de gastroenterologie 08/2009; 23(7):477-8. · 1.98 Impact Factor

  • 11/2012; 19(6):308-311.
Show more