title: Endoscopic management of a rare granulation polyp in a colonic diverticulum.
abstract: There are many case reports on colon diverticula that cause irritable bowel syndrome, constipation, bleeding, diverticulitis, stricture due to multiple recurrences of diverticulitis, and perforation. However, few articles have examined neoplasms that arise from a diverticulum, such as adenoma and adenocarcinoma, and there have been no reports of granulation polyps that arise from a colon diverticulum after recurrent diverticulitis. We observed a rare granulation polyp that arose from a diverticulum as a result of repeated episodes of local diverticulitis. Narrow band imaging magnified colonoscopy was very useful to diagnose the polyp as a granulation polyp because of the absence of a pit pattern on the surface of the polyp. We successfully resected the polyp using endoscopic mucosal resection. We inverted the diverticulum, and the resected stalk of the polyp was used to close the diverticulum with an over-the-scope clip. If a granulomatous polyp could arise from a diverticulum, differential diagnosis between a colon neoplasm and a granulomatous polyp would not only be difficult but also necessary for suitable endoscopic treatment.
authors.affiliation: Hirohito Mori, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Tae Matsunaga, Maki Ayagi, Tatsuo Yachida, Tsutomu Masaki, Departments of Gastroenterology and Neurology, Kagawa University School of Medicine, Kagawa 761-0793, Japan.
authors.forename: Hirohito
authors.initials: H
authors.lastname: Mori
authors.affiliation: Hirohito Mori, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Tae Matsunaga, Maki Ayagi, Tatsuo Yachida, Tsutomu Masaki, Departments of Gastroenterology and Neurology, Kagawa University School of Medicine, Kagawa 761-0793, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Tsushimi
authors.affiliation: Hirohito Mori, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Tae Matsunaga, Maki Ayagi, Tatsuo Yachida, Tsutomu Masaki, Departments of Gastroenterology and Neurology, Kagawa University School of Medicine, Kagawa 761-0793, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Kobara
authors.affiliation: Hirohito Mori, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Tae Matsunaga, Maki Ayagi, Tatsuo Yachida, Tsutomu Masaki, Departments of Gastroenterology and Neurology, Kagawa University School of Medicine, Kagawa 761-0793, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Nishiyama
authors.affiliation: Hirohito Mori, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Tae Matsunaga, Maki Ayagi, Tatsuo Yachida, Tsutomu Masaki, Departments of Gastroenterology and Neurology, Kagawa University School of Medicine, Kagawa 761-0793, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Fujihara
authors.affiliation: Hirohito Mori, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Tae Matsunaga, Maki Ayagi, Tatsuo Yachida, Tsutomu Masaki, Departments of Gastroenterology and Neurology, Kagawa University School of Medicine, Kagawa 761-0793, Japan.
authors.forename: Tae
authors.initials: T
authors.lastname: Matsunaga
authors.affiliation: Hirohito Mori, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Tae Matsunaga, Maki Ayagi, Tatsuo Yachida, Tsutomu Masaki, Departments of Gastroenterology and Neurology, Kagawa University School of Medicine, Kagawa 761-0793, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Ayagi
authors.affiliation: Hirohito Mori, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Tae Matsunaga, Maki Ayagi, Tatsuo Yachida, Tsutomu Masaki, Departments of Gastroenterology and Neurology, Kagawa University School of Medicine, Kagawa 761-0793, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Yachida
authors.affiliation: Hirohito Mori, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Tae Matsunaga, Maki Ayagi, Tatsuo Yachida, Tsutomu Masaki, Departments of Gastroenterology and Neurology, Kagawa University School of Medicine, Kagawa 761-0793, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Masaki
mesh_terms: D001706:Biopsy; D003111:Colonic Polyps / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003113:Colonoscopy; D003937:Diagnosis, Differential; D004241:Diverticulum, Colon / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006097:Granulation Tissue / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Diverticulitis; Endoscopy; Granulation polyp; Mucosal resection; Neoplasm; Recurrence