Published online Jan 21, 2015. doi: 10.3748/wjg.v21.i3.1044
Peer-review started: June 3, 2014
First decision: June 27, 2014
Revised: July 29, 2014
Accepted: September 18, 2014
Article in press: September 19, 2014
Published online: January 21, 2015
Processing time: 232 Days and 4.8 Hours
Ulcerative colitis in addition to inflammatory polyposis is common. The benign sequel of ulcerative colitis can sometimes mimic colorectal carcinoma. This report describes a rare case of inflammatory polyposis with hundreds of inflammatory polyps in ulcerative colitis which was not easy to distinguish from other polyposis syndromes. A 16-year-old Chinese male suffering from ulcerative colitis for 6 mo underwent colonoscopy, and hundreds of polyps were observed in the sigmoid, causing colonic stenosis. The polyps were restricted to the sigmoid. Although rectal inflammation was detected, no polyps were found in the rectum. A diagnosis of inflammatory polyposis and ulcerative colitis was made. The patient underwent total colectomy and ileal pouch anal anastomosis. The patient recovered well and was discharged on postoperative day 8. Endoscopic surveillance after surgery is crucial as ulcerative colitis with polyposis is a risk factor for colorectal cancer. Recognition of polyposis requires clinical, endoscopic and histopathologic correlation, and helps with chemoprophylaxis of colorectal cancer, as the drugs used postoperatively for colorectal cancer, ulcerative colitis and polyposis are different.
Core tip: This case report describes ulcerative colitis with inflammatory polyps in a teenage boy. The macropathology of inflammatory polyps excised from the colon was similar to that of familial adenomatous polyps and hyperplastic polyps. In this article, we discuss the difficulties in distinguishing inflammatory polyposis from similar polyps and emphasize the importance of the chemoprophylaxis of colorectal cancer developed from ulcerative colitis and polyps.