378 duodenal polyps were identified by endoscopic biopsy since 1973 in the course of more than 25,000 oesophago-gastro-duodenoscopies, corresponding to an incidence rate of 1.5%. Heterotopias of the gastric mucosa and so-called inflammatory polyps were most frequent (35.7% and 35.2%, respectively), followed by hyperplasia of Brunner's glands (6.9%), lipid islets (2.9%) and lymphatic hyperplasia (1.8%). Histologically there was no correlate to the endoscopic findings. Hence, non-neoplastic polyps account for about 90% of duodenal polyps; they are harmless and generally produce no (or only minor) signs or symptoms. Clinically relevant polyps besides the primary and secondary malignant processes are the adenomas of the colon type (6.9%) and Peutz-Jeghers polyps (1.3%). Since these two may occur in gastrointestinal polyposis, "top-and-tail endoscopy" must be performed. The rate of complications of 15% in endoscopic loopectomy in the duodenum is clearly higher than that in the stomach and colon.
We report on a 45-year-old woman with ulcerative colitis of the rectum that arose after the use of up to 6 suppositories of a preparation containing ergotamine daily over a period of 6 years. On the basis of a review of the literature the clinical, endoscopic and histological features of the ergotamine-induced colitis are characterized.
Endoscopic polypectomy has brought a pragmatic solution to the problems associated with the frequent occurrence of polyps in the upper gastrointestinal tract. In 276 polypectomies performed in 181 patients, complications were observed in only 1.4"/o. Neither perforation nor lethal complication was observed. Comparison between histological examination of the biopsy specimens obtained prior to polypectomy and the histological findings in the polyps removed in toto showed differing pattern in 54 of 120 gastric polyps. This was due to the fact that mixed forms of polyps and mesenchymal tumours are not established with the forceps biopsy. 3.3°/o of all the polyps removed were malignant. Patients with hyperplasiogenic gastric polyps seem to have an increased cancer risk. Gastroscopic screening examinations carried out every 6 month are therefore recommended in these patients. Key-Words: Endoscopic polypectomy, gastric polyps, polyps of the upper gastrointestinal tract. Up until few years ago, endoscopy of the upper gastrointestinal tract was restricted to the diagnosis of circumscribed lesions. The greatest advance in gastroenterological diagnosis and therapy was endoscopic polypectomy which represented a pragmatic solution of the problems associated with the frequent finding of polyps in the upper gastrointestinal tract.Risks, costs and time required to perform gastroscopic polypectomy are considerably reduced as compared with surgical polypectomy. Gastroscopic polypectomy can be carried out during a routine oesophagogastro-duodenoscopic examination and lengEndoscopy 7 (1975) 216-221 0 Georg Thieme Verlag, Stuttgart Endoskopische Polypektomie im oberen Verdauungstrakt Die endoskopische Polypektomie hat eine pragmatische Lösung der Probleme ermöglicht, die mit dem häufigen Vorkommen von Polypen im oberen Verdauungstrakt verbunden sind. Bei 276 endoskopischen Polypektomien bei 181 Patienten traten nur in 1,4°/o Komplikationen auf. Es wurde weder eine Perforation noch eine andere letale Komplikation beobachtet. Beim Vergleich der histologischen Befunde von Biopsiepartikeln vor Polypektomie und der ektomierten Polypen ergaben sich differente Befunde bei 54 von 120 Magenpolypen. Das ist darauf zuriickzufiihren, dal; Mischformen und mesenchymale Tumoren durch die Zangenbiopsie nicht erfaßt werden. 3,30/o aller entfernten Polypen waren maligne. Patienten mit hyperplasiogenen Magenpolypen scheinen ein erhöhtes Karzinomrisiko des befallenen Magens aufzuzeigen. Gastroskopische Kontrolluntersuchungen in einem Abstand von etwa 6 Monaten sind daher bei diesen Patienten erforderlich.thens the examination only to a small extent. The patient remains hospitalized overnight for follow-up observation. The complicationrate for endoscopic polypectomy is low and the procedure is painless. In consequence, gastroscopic polypectomy can also be employed in elderly, high-risk patients.Every polyp seen during gastroscopy should be removed in toto. The term "polyp" can be associated with widely varying histological substrates. Only the histologic...
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