Clin Endosc.  2012 Sep;45(3):198-201.

A Case of Giant Inflammatory Ileal Polyp Removed by Double-Balloon Enteroscopy

• Yoon DW
• Lee BJ
• Lee JH
• Park JJ
• Kim JS
• Bak YT
• Choi WJ
• Mok YJ

Abstract

Inflammatory fibroid polyps are rare benign tumors of the GI tract, that commonly present with intestinal obstruction as a result of intussusceptions in the small bowel. A 39-year old man visited our clinic with an asymptomatic polypoid mass in the distal ileum that was identified on abdominal computed tomography for postoperative surveillance after total gastrectomy due to previously diagnosed early gastric cancer. Retrograde double-balloon enteroscopy was performed to diagnose the ileal mass and a complete resection of the polyp was performed using snare for polypectomy without complications. The final histological finding was an ileal inflammatory polyp. Balloon-assisted enteroscopy is a valuable modality to diagnose and treat small bowel lesions in lieu of surgical procedures in selected cases.

Keyword

Small bowel; Inflammatory polyp; Double-balloon enteroscopy

MeSH Terms

Double-Balloon Enteroscopy
Gastrectomy
Gastrointestinal Tract
Ileum
Intestinal Obstruction
Intussusception
Leiomyoma
Polyps
SNARE Proteins
Stomach Neoplasms
SNARE Proteins

Figure

• 

  Fig. 1 (A) Abdominal computed tomography (CT) showing an about 1.6 cm sized polypoid mass in the distal ileum. (B) Increased size of the mass to about 2.5 cm was noted at abdominal CT findings one year later.

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  Fig. 2 Double-balloon enteroscopic finding of ileal polyp. A large, pedunculated polypoid nodular mass with scattered whitish pigmentation in the distal ileum, located 50 to 60 cm from the ileocecal valve. Snare polypectomy was performed after the injection of an indigocarmine-epinephrine mixture (A, B, C).

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  Fig. 3 Hematoxylin & eosin stain shows an inflammatory polyp. The lesion is submucosal based and extends into the mucosa. (A) Proliferation of the highly vascular fibrous tissue is observed (H&E-stain ×12.5). (B) The high magnification view shows proliferation of bland spindle cells with infiltration of mixed inflammatory cells, including eosinophils, lymphocytes, and plasma cells (H & E stain, ×200).

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