A Gastric Hyperplastic Polyp Observed Endoscopically Before and After Autoamputation

Abstract

Autoamputation of a gastric polyp is a relatively rare phenomenon and its precise mechanism is unclear. To learn more about the mechanism(s) involved, it is important to observe a polyp just before and just after its disappearance. We report a case of a gastric polyp that was observed endoscopically just before and then just after autoamputation. A 61-year-old woman with a thumb-sized, pedunculated hyperplastic polyp in the gastric antrum visited our institution for investigation of hematemesis. She was being treated with oral hypoglycaemic drugs for diabetes mellitus but was not taking any other medicine around that time. Emergency gastroscopy revealed a bleeding point near the polyp; gastroscopy the next day revealed that the polyp had disappeared. It was concluded that autoamputation of a gastric polyp may follow gastric injury induced by diabetes mellitus or oral antidiabetic drugs.

Autoamputation of a Giant Colonic Lipoma

“…Autoamputation of colonic lipoma is indeed rare clinical presentation 4-10. The underlying mechanisms of this presentation are still poorly understood.…”

“…Torsion or tension may result in twisting polyp, causing ischemic necrosis and tearing of the polyp base or amputation. Especially, pedunculated polyps may be easily distorted and are subjected to mechanical tension 4-10. In our case, colonoscopy revealed a huge movable mass with focally ulceration and hemorrhagic mucosa in the rectum and remnant long stalk with necrotic and ulcerative tissue on the transverse colon.…”

“…Autoamputation of polypoid lesions in gastrointestinal tract is an extremely rare phenomenon 4-10. But the precise mechanism of the phenomenon remains unknown.…”

“…But the precise mechanism of the phenomenon remains unknown. It presumably occurs because of ischemic necrosis of polyp by peristalsis induced torsion or tension 4-10…”

Answer

“…Autoamputation has been reported for juvenile polyps, but rarely in the stomach1 and colon2 in adults. Moreover, this process has been observed radiologically, such as recently in a case of pedunculated duodenal polyp 3.…”