Murata M, Sugimoto M, Ban H, Otsuka T, Nakata T, Fukuda M, Inatomi O, Bamba S, Kushima R, Andoh A. Cap polyposis refractory to Helicobacter pylori eradication treated with endoscopic submucosal dissection. World J Gastrointest Endosc 2017; 9(10): 529-534 [PMID: 29085564 DOI: 10.4253/wjge.v9.i10.529]
Corresponding Author of This Article
Mitsushige Sugimoto, MD, PhD, Division of Digestive Endoscopy, Shiga University of Medical Science Hospital, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan. sugimo@belle.shiga-med.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Masaki Murata, Taketo Otsuka, Toshiro Nakata, Osamu Inatomi, Shigeki Bamba, Akira Andoh, Department of Gastroenterology, Shiga University of Medical Science Hospital, Otsu 520-2192, Japan
Mitsushige Sugimoto, Hiromitsu Ban, Division of Digestive Endoscopy, Shiga University of Medical Science Hospital, Otsu 520-2192, Japan
Masahide Fukuda, Ryoji Kushima, Department of Clinical Laboratory Medicine, Shiga University of Medical Science Hospital, Otsu 520-2192, Japan
Author contributions: Murata M, Sugimoto M, Ban H, Otsuka T, Nakata T, Fukuda M, Inatomi O, Bamba S, Kushima R and Andoh A collected and analyzed the patient’s clinical data and wrote the paper.
Institutional review board statement: Approval of this case report was not given in advance by the Institutional Review Board of Shiga University of Medical Science.
Informed consent statement: A patient of this case provided informed written consent prior to the endoscopic procedure and treatment.
Conflict-of-interest statement: No conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mitsushige Sugimoto, MD, PhD, Division of Digestive Endoscopy, Shiga University of Medical Science Hospital, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan. sugimo@belle.shiga-med.ac.jp
Telephone: +81-77-5482618 Fax: +81-77-5482618
Received: April 6, 2017 Peer-review started: April 10, 2017 First decision: May 16, 2017 Revised: May 24, 2017 Accepted: June 30, 2017 Article in press: July 3, 2017 Published online: October 16, 2017 Processing time: 190 Days and 1.5 Hours
Abstract
Cap polyposis is a rare intestinal disorder. Characteristic endoscopic findings are multiple inflammatory polypoid lesions covered by caps of fibrous purulent exudate. Although a specific treatment has not been established, some studies have suggested that eradication therapy for Helicobacter pylori (H. pylori) is effective. We report a case of a 20-year-old man with cap polyposis presenting with hematochezia. Colonoscopy showed the erythematous polyps with white caps from the sigmoid colon to rectum. Histopathological findings revealed elongated, tortuous, branched crypts lined by hyperplastic epithelium with a mild degree of fibromusculosis in the lamina propria. Although H. pylori eradication was instituted, there was no improvement over six months. We then performed en bloc excision of the polyps by endoscopic submucosal dissection (ESD), which resulted in complete resolution of symptoms. ESD may be a treatment option for cap polyposis refractory to conservative treatments. We review the literature concerning treatment for cap polyposis and clinical outcomes.
Core tip: Although for cap polyposis, conservative treatment should be selected as first-line therapy, the optimal treatment of cap polyposis refractory to conservative treatment has not been established. Endoscopic submucosal dissection may be a treatment option for cases refractory to conservative treatment.
