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Digestive Diseases and Sciences

, Volume 31, Issue 10, pp 1159–1167 | Cite as

Inflammatory polyposis two years after ischemic colon injury

  • Douglas S. Levine
  • Christina M. Surawicz
  • Gerald D. Spencer
  • Charles A. Rohrmann
  • Fred E. Silverstein
Case Report

Summary

Inflammatory polyps occur in association with ulcerative colitis, Crohn's disease, and other inflammatory diseases of the colon. The occurrence of inflammatory polyps following ischemic colitis has not been well documented. A 49-year-old man suffered complications of hypoperfusion, including renal insufficiency, hepatic failure, shock lung, and ischemic colitis following emergent repair of an acute aortic dissection. Although the renal, hepatic, and pulmonary complications resolved, the patient continued to experience intermittent bloody diarrhea more than two years after his initial presentation. Barium enema and colonoscopy revealed numerous pedunculated polyps in the descending and sigmoid colon. Histopathology of the polyps removed by snare electrocautery showed them to be inflammatory polyps. We believe these are the sequelae of chronic ischemic colitis.

Keywords

Diarrhea Ulcerative Colitis Aortic Dissection Sigmoid Colon Hepatic Failure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Lumb G: Pathology of ulcerative colitis. Gastroenterology 40:290–298, 1961Google Scholar
  2. 2.
    Jalan KN, Sircus W, Walker RJ, McManus JPA, Prescott RJ, Card WI: Pseudopolyposis in ulcerative colitis. Lancet 2:555–559, 1969Google Scholar
  3. 3.
    Teague RH, Read AE: Polyposis in ulcerative colitis. Gut 16:792–795, 1975Google Scholar
  4. 4.
    Munyer TP, Montgomery CK, Thoeni RF, Goldberg HI, Margulis AR: Postinflammatory polyposis (PIP) of the colon: The radiologic-pathologic spectrum. RAdiology 145:607–614, 1982Google Scholar
  5. 5.
    Nixon JB, Riddell RH: Histopathology of ulcerative colitis.In Inflammatory Bowel Diseases. RN Allan, MRB Keighley, J Alexander-Williams, C Hawkins (eds). Edinburgh, Churchill-Livingstone, 1983, pp 194–209Google Scholar
  6. 6.
    Renison DM, Forouhar FA, Levine JB, Breiter JR: Filiform polyposis of the colon presenting as massive hemorrhage: An uncommon complication of Crohn's disease. Am J Gastroenterol 78:413–416, 1983Google Scholar
  7. 7.
    Welch CE: Unusual polypoid lesions of the colon and rectum. Major Probl Clin Surg 2:82–97, 1964Google Scholar
  8. 8.
    Nebel OT, El Masry NA, Castell DO, Farid Z, Fornes MF, Sparks HA: Schistosomal disease of the colon: A reversible form of polyposis. Gastroenterology 67:939–943, 1974Google Scholar
  9. 9.
    Berkowitz D, Bernstein LH: Colonic pseudopolyps in association with amebic colitis. Gastroenterology 68:786–789, 1975Google Scholar
  10. 10.
    Brock DR, Suckow EE: Obliterative arteriolarsclerosis of the colon with focal mucosal necrosis. Gastroenterology 44:190–194, 1963Google Scholar
  11. 11.
    Price AB: Benign lymphoid polyps and inflammatory polyps. Major Probl Pathol 10:33–42, 1978Google Scholar
  12. 12.
    Segal I, Soloman A, Mirwis J: Radiological manifestations of ritual enema-induced colitis. Clin Radiol 32:657–662, 1981Google Scholar
  13. 13.
    Goldman H, Antonioli DA: Mucosal biopsy of the rectum, colon, and distal ileum. Hum Pathol 13:981–1012, 1982Google Scholar
  14. 14.
    Goldman H, Ming S, Hickok DF: Nature and significance of hyperplastic polyps of the human colon. Arch Pathol 89:349–354, 1970Google Scholar
  15. 15.
    Estrada RG, Spjut HJ: Hyperplastic polyps of the large bowel. Am J Surg Pathol 4:127–133, 1980Google Scholar
  16. 16.
    Williams GT, Arthur JF, Bussey HJR, Morson BC: Metaplastic polyps and polyposis of the colorectum. Histopathology 4:155–170, 1980Google Scholar
  17. 17.
    Boland CR, Kim YS: Colonic polyps and the gastrointestinal polyposis syndromes.In Gastrointestinal Disease: Pathophysiology, Diagnosis, Management, 34d ed. MH Sleisenger, JS Fordtran (eds). Philadelphia, Saunders, 1983, pp 1196–1219Google Scholar
  18. 18.
    Evers K, Laufer I: Ulcerative colitis: radiology.In Inflammatory Bowel Diseases. RN Allan, MRB Keighley, J Alexander-Williams, C Hawkins (eds). Edinburgh, Churchill-Livingstone, 1983, pp 177–193Google Scholar
  19. 19.
    Riddell RH, Goldman H, Ransohoff DF, Appelman HD, Fenoglio CM, Haggitt RC, Ahren C, Correa P, Hamilton SR, Morson BC, Sommers SC, Yardley JH: Dysplasia in inflammatory bowel disease: Standardized classification with provisional clinical applications. Hum Pathol 14:931–968, 1983Google Scholar
  20. 20.
    Payan H, Levine S, Bronstein L, King E: Subtotal ischemic infarction of colon simulating ulcerative colitis. Arch Pathol 80:530–533, 1965Google Scholar
  21. 21.
    Kilpatrick ZM, Farman J, Yesner R, Spiro HM: Ischemic proctitis. JAMA 205:64–70, 1968Google Scholar
  22. 22.
    Morson BC, Dawson IMP: Gastrointestinal Pathology, 2nd ed. Oxford, Blackwell, 1979Google Scholar
  23. 23.
    Eisenberg RL, Montgomery CK, Margulis AR: Colitis in the elderly: Ischemic colitis mimicking ulcerative and granulomatous colitis. Am J Roentgenol 133:1113–1118, 1979Google Scholar
  24. 24.
    Dawson IMP: Atlas of Gastrointestinal Pathology as Seen on Biopsy. Philadelphia, Lippincott, 1983Google Scholar
  25. 25.
    Wittenberg J, Athanasoulis CA, Williams LF, Paredes S, O'Sullivan P, Brown B: Ischemic colitis: radiology and pathophysiology. Am J Roetgenol 123:287–300, 1975Google Scholar
  26. 26.
    Westcott JL: Angiographic demonstration of arterial occlusion in ischemic colitis. Gastroenterology 63:486–490, 1972Google Scholar
  27. 27.
    Earnest DL, Trier JS: Radiation enteritis and colitis.In Gastrointestinal Disease: Pathophysiology, Diagnosis, Management, 3rd ed. MH Sleisenger, JS Fordtran (eds). Philadelphia, Saunders, 1983, pp 1259–1268Google Scholar
  28. 28.
    Boley SJ, Schwartz SS: Colonic ischemia: Reversible ischemic lesions.In Vascular Disroders of the Intestine. SJ Boley, SS Schwartz, LF Williams (eds). New York, Appleton-Century-Crofts, 1971, pp 579–596Google Scholar
  29. 29.
    Marston A: Irreversible vascular lesions of the colon.In Vascular Disorders of the Intestine. SJ Boley, SS Schwartz, LF Williams (eds). New York, Appleton-Century-Crofts, 1971, pp 597–611Google Scholar
  30. 30.
    Marcuson RW: Ischemic colitis. Clin Gastroenterol 1:745–763, 1972Google Scholar
  31. 31.
    Marston A. Intestinal Ischemia. London, Edward Arnold, 1977Google Scholar
  32. 32.
    Marston A, Pheils MT, Thomas ML, Morson BC: Ischemic colitis. Gut 7:1–15, 1966Google Scholar
  33. 33.
    Ferrara JJ: Spontaneous ischemic colitis.In Intestinal Ischemia. M Cooperman (ed). New York, Futura, 1983, pp 245–260Google Scholar
  34. 34.
    Marston A: Ischemic disease of the colon.In Diseases of the Colon, Rectum and Anus. BC Morson (ed). New York, Appleton-Century-Crofts, 1969, pp 218–230Google Scholar
  35. 35.
    Morson BC: Histopathology of intestinal ischemia.In Vascular Disorders of the Intestine. SJ Boley, SS Schwartz, LF Williams (eds). New York, Appleton-Century-Crofts, 1971, pp 103–121Google Scholar
  36. 36.
    Morson BC: Pathology of ischemic colitis. Clin Gastroenterol 1:765–766, 1972Google Scholar
  37. 37.
    Whitehead R: The pathology of intestinal ischemia. Clin Gastroenterol 1:613–637, 1972Google Scholar
  38. 38.
    Rotterdam H, Sommers SC: Biopsy Diagnosis of the Digestive Tract. New York, Raven Press, 1981Google Scholar
  39. 39.
    Clausen KP, Lucas JG: Pathology of ischemic bowel disease.In Intestinal Ischemia. M Cooperman (ed). New York, Futura, 1983, pp 29–48Google Scholar
  40. 40.
    O'Connell TX, Tompkins RK: Ischemia of the colon. Surg Gynecol Obstet 142:337–342, 1976Google Scholar
  41. 41.
    Brandt LJ: Ischemic disorders of the intestine.In Gastrointestinal Disorders of the Elderly. New York, Raven Press, 1984, pp 368–421Google Scholar
  42. 42.
    Goldberg SM, Gordon PH, Nivatvongs S: Essentials of Anorectal Surgery. Philadelphia, Lippincott, 1980Google Scholar
  43. 43.
    McColl I, Bussey HJR, Morson BC: Polyps and polyposis.In Diseases of the Colon, Rectum and Anus. BC Morson (ed). New York, Appleton-Century-Crofts, 1969, pp 91–103Google Scholar
  44. 44.
    Norris HT: Ischemic bowel disease: Its spectrum.In The Gastrointestinal Tract. JH Yardley, BC Morson, MR Abell (eds). Baltimore, Williams and Wilkins, 1977, pp 15–35Google Scholar
  45. 45.
    Schwartz S, Boley SJ, Robinson K, Krieger H, Schultz L, Allen AC: Roentgenologic features of vascular disorders of the intestines. Radiol Clin North Am 2:71–87, 1964Google Scholar
  46. 46.
    Yardley JH, Donowitz M: Colorectal biopsy in inflammatory bowel disease.In The Gastrointestinal Tract. JH Yardley, BC Morson, MR Abell (eds). Baltimore, Williams and Wilkins, 1977, pp 50–94Google Scholar
  47. 47.
    Teague RH, Waye JD: Inflammatory bowel disease.In Colonoscopy: Techniques, Clinical Practice and Color Atlas. RH Hunt, JD Waye (eds). London, Chapman and Hall, 1981, pp 343–362Google Scholar
  48. 48.
    Shinya H: Colonoscopy: Diagnosis and Treatment of Colonic Diseases. Tokyo, Igaku-Shoin, 1982Google Scholar

Copyright information

© Plenum Publishing Corporation 1986

Authors and Affiliations

  • Douglas S. Levine
    • 1
  • Christina M. Surawicz
    • 1
  • Gerald D. Spencer
    • 1
  • Charles A. Rohrmann
    • 1
  • Fred E. Silverstein
    • 1
  1. 1.Division of Gastroenterology, Departments of Medicine and RadiologyUniversity of WashingtonSeattle

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