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

Figure 1 Contrast-enhanced abdominal computed tomography scan. Contrast-enhanced abdominal computed tomography scan shows extravascular leakage of the contrast medium from the left wall of the lower rectum (red arrow).

Figure 2 Endoscopic hemostasis and polypectomy. A: Pulsatile bleeding is observed from the stem of the polyp; B: Endoscopic hemostasis is performed by clipping the stem; C: Polypectomy is then performed above the clip to examine the tissue; D: The clips are added to completely stop the bleeding.

Figure 3 Histopathological evaluation. A: Hematoxylin and eosin staining showing large blood vessels in the stalk (red box) and some dilated glandular ducts on the cyst (yellow arrowheads); B: Desmin staining showing intricate lamina muscularis mucosae. There are no signs of malignancy, such as tearing or disruption of the lamina.

Figure 4 Semi-pedunculated polyps near the clipped bleeding site in the rectum. A: Two semi-pedunculated polyps, approximately 15 mm in diameter (arrow 1 and arrow 2), are visible near the clipped bleeding site in the rectum; B and C: The polyps are intensely erythematous and have smooth surfaces and erosions with moss-white colorings; D and E: Narrow band imaging reveals dilated glands.

Figure 5 Histopathological evaluation of juvenile polyps. A: Glandular ducts with dilated lumens distributed in the polyp; B: At the stem of the polyp (blue box in panel A, the lamina muscularis mucosae are present (dotted circle); C: Whereas in the head (green box in panel A), the lamina muscularis mucosae are lacking and a high inflammatory cell infiltrate is present (dotted circle).