COLONIC POLYPS

TUBULAR ADENOMAS

Present in ∼30% of adults; pedunculated or sessile; usually asymptomatic; ∼5% cause occult blood in stool; may cause obstruction; overall risk of malignant degeneration correlates with size (<2% if <1.5 cm in diameter; >10% if >2.5 cm in diameter) and is higher in sessile polyps; 65% found in rectosigmoid colon; diagnosis by barium enema, sigmoidoscopy, or colonoscopy. Treatment: Full colonoscopy to detect synchronous lesions (present in 30%); endoscopic resection (surgery if polyp large or inaccessible by colonoscopy); follow-up surveillance by colonoscopy every 2–3 years.

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