title: Juvenile polyposis of the stomach causing recurrent upper gastrointestinal bleeding.
abstract: We present the case of a 42-year-old man who suffered from recurrent severe upper gastrointestinal bleeding starting from February 2003. Endoscopy showed multiple glassy polyps in the stomach, which corresponded to a diffuse mucosal thickening detected by endosonography. The duodenum was normal. In February 2006, life-threatening acute gastrointestinal bleeding prompted total gastrectomy. The resection specimen showed the gastric mucosa carpeted by numerous glassy pedunculated polyps, measuring 2 cm in largest diameter. Histologically, the polyps were characterized by an abundant loose stroma and by elongated, twisting foveolae, covered by hyperplastic epithelium. Colonoscopy including the terminal ileum revealed a single tubulovillous adenoma, but no hamartomatous polyps, rendering a final diagnosis of juvenile polyposis of the stomach. This case represents the first description of juvenile polyposis causing life-threatening gastric haemorrhage. Thus, although rare, the disease has to be considered in the differential diagnosis of patients with acute upper gastrointestinal tract bleeding.
authors.affiliation: Institute of Pathology, Medical University Graz, Graz, Austria.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Winkler
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Hinterleitner
authors.forename: Christoph
authors.initials: C
authors.lastname: Högenauer
authors.forename: Hubert
authors.initials: H
authors.lastname: Hauser
authors.forename: Cord
authors.initials: C
authors.lastname: Langner
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000150:complications* / Q000473:pathology; D000328:Adult; D005753:Gastric Mucosa / Q000473:pathology; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D011127:Polyps / Q000150:complications* / Q000473:pathology; D012008:Recurrence; D013274:Stomach Neoplasms / Q000150:complications* / Q000473:pathology