Perforation of sigmoid diverticulum following endoscopic polypectomy of an adenoma

Abstract

Colonic polyps or carcinomas located within a colonic diverticulum are very rare phenomena. There are a few reports in the literature describing adenocarcinoma arising within colonic diverticulum. Endoscopic resection of the polyp poses a risk of perforation because of the lack of muscular coats in the diverticulum. Therefore, special care should be taken in the treatment of such patients.

Endoscopic Management of Polyps Arising From Diverticula

“…Other techniques described in a few case reports include endoscopic band ligation and the use of over-the-scope clips with full-thickness colon resection. 2 – 5 To the best of our knowledge, this is the first series of cases that demonstrate successful removal of diverticular polyps using EMR without any complications, but more cases are needed to validate this technique as a standard of care. Informed consent could not be obtained from the patient despite several attempts.…”

Endoscopic Management of a Tubulovillous Adenoma Within a Diverticulum: Report of a Case and Review of Literature

“…Adenomatous polyps are the most prevalent neoplastic polyps in the colon and comprise approximately two-thirds of all colonic polyps [ 1 ]. Adenomas or adenocarcinomas located within a diverticulum are a rare phenomenon that has been described in the literature [ 2 - 5 ]. These lesions pose a technical challenge for endoscopic management given their difficult location inside the diverticulum and the greater risk of perforation upon endoscopic resection owing to the lack of the muscular layer within the diverticulum [ 4 - 6 ].…”

Cold snare polypectomy in combination with a traction device for resection of a colonic adenoma partially extending into a diverticulum

“…Endoscopic resection-related adverse events have been reported. 1 In recent years, cold snare polypectomy (CSP) has been widely performed for small colorectal tumors. 2 CSP causes less delayed bleeding and has shorter procedure times compared with hot snare polypectomy.…”