The two towers
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History
A 48-year-old patient with a positive fecal occult blood test (FOBT) was referred for colonoscopy as part of the screening program.
Clinical & biological
No symptoms.
Imaging
Two pedunculated polyps (Paris Ips) were visualised in the sigmoid with iSCAN 1,2 aspect and OE (optical enhancement) revealing a gtyrus-like pattern (J-NET2A / Kudo IIIL) (Figure 1-2, Video 1). At the base of the polyps edema is observed (chicken skin appearance) due to traction in the colonic mucosa.
Polyps were resected by endoscopic polypectomy after injection of 5 mL 1:10 000 epinephrine diluted in Gelofusine + methylene blue (MB), without complications (Figure 3-4, Video 2). Two hemostatic clips were placed at the end of the procedure (Figure 5-6, Video 3).
Diagnosis
Discussion
Rare case of polyps located in the proximal colon.
Conclusions
The detailed examination allows to establish the correct polypectomy technique.
References
1. Bianchi M, Clemente V, Koch M. The "Siamese twins" polyps. Dig Liver Dis 2015; 47(4): 346.
2. Benatta MA, Desjeux A, Grimaudb JC. A double-headed polyp. Ann Gastroenterol 2013; 26(1): 72.
3. Olson MR, Govil YK. Two polyps on a common stalk. Gastrointest Endosc 2011; 74(3): 692.
