Prolapsing gastric polyp causing intermittent gastric outlet obstruction

Nik Ritza Kosai Nik Mahmood, Hardip Singh Gendeh, Abdul Rashid Norfaezan, Razman Jarmin, Paul Anthony Sutton, Srijit Das

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Gastric polyps are often an incidental finding on upper gastrointestinal endoscopy, with an incidence up to 5%. The majority of gastric polyps are asymptomatic, occurring secondary to inflammation. Prior reviews discussed Helicobacter pylori (H pylori)- associated singular gastric polyposis; however, we present a rare and unusual case of recurrent multiple benign gastric polyposis post H pylori eradication resulting in intermittent gastric outlet obstruction. A 70-year-old independent male, Chinese in ethnicity, with a background of diabetes mellitus, hypertension, and a simple renal cyst presented with a combination of melena, anemia, and intermittent vomiting of partially digested food after meals. Initial gastroscopy was positive for H pylori; thus he was treated with H pylori eradication and proton pump inhibitors. Serial gastroscopy demonstrated multiple sessile gastric antral polyps, the largest measuring 4 cm. Histopathologic examination confirmed a benign hyperplastic lesion. Computed tomography identified a pyloric mass with absent surrounding infiltration or metastasis. A distal gastrectomy was performed, whereby multiple small pyloric polyps were found, the largest prolapsing into the pyloric opening, thus explaining the intermittent nature of gastric outlet obstruction. Such polyps often develop from gastric ulcers and, if left untreated, may undergo neoplasia to form malignant cells. A distal gastrectomy was an effective choice of treatment, taking into account the polyp size, quantity, and potential for malignancy as opposed to an endoscopic approach, which may not guarantee a complete removal of safer margins and depth. Therefore, surgical excision is favorable for multiple large gastric polyps with risk of malignancy.

Original languageEnglish
Pages (from-to)1148-1152
Number of pages5
JournalInternational Surgery
Volume100
Issue number6
DOIs
Publication statusPublished - 1 Jun 2015

Fingerprint

Gastric Outlet Obstruction
Polyps
Stomach
Helicobacter pylori
Gastroscopy
Gastrectomy
Melena
Neoplasms
Incidental Findings
Gastrointestinal Endoscopy
Proton Pump Inhibitors
Stomach Ulcer
Vomiting
Meals
Cysts
Anemia
Diabetes Mellitus
Tomography
Neoplasm Metastasis
Hypertension

Keywords

  • Gastric obstruction
  • Gastric polyp
  • Surgical management

ASJC Scopus subject areas

  • Surgery

Cite this

Prolapsing gastric polyp causing intermittent gastric outlet obstruction. / Nik Mahmood, Nik Ritza Kosai; Gendeh, Hardip Singh; Norfaezan, Abdul Rashid; Jarmin, Razman; Sutton, Paul Anthony; Das, Srijit.

In: International Surgery, Vol. 100, No. 6, 01.06.2015, p. 1148-1152.

Research output: Contribution to journalArticle

Nik Mahmood, Nik Ritza Kosai ; Gendeh, Hardip Singh ; Norfaezan, Abdul Rashid ; Jarmin, Razman ; Sutton, Paul Anthony ; Das, Srijit. / Prolapsing gastric polyp causing intermittent gastric outlet obstruction. In: International Surgery. 2015 ; Vol. 100, No. 6. pp. 1148-1152.
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