Pseudopolyps in inflammatory bowel diseases: Have we learned enough?
Pseudopolyps are a well described entity in the literature and even though the exact pathogenesis of their formation is not completely understood, they are considered non-neoplastic lesions originating from the mucosa after repeated periods of inflammation and ulceration associated with excessive healing processes. Their occurrence is less common in Crohn's disease than in ulcerative colitis, and their overall prevalence ranges from 4% to 74%; moreover, they are found more often in colon but have been detected in other parts of the gastrointestinal tract as well. When their size exceeds the arbitrary point of 1.5 cm, they are classified as giant pseudopolyps. Clinical evaluation should differentiate the pseudopolyps from other polypoid lesions, such as the dysplasia-associated mass or lesion, but this situation represents an ongoing clinical challenge. Pseudopolyps can provoke complications such as bleeding or obstruction, and their management includes medical therapy, endoscopy and surgery; however, no consensus exists about the optimal treatment approach. Patients with pseudopolyps are considered at intermediate risk for colorectal cancer and regular endoscopic monitoring is recommended. Through a review of the literature, we provide here a proposed classification of the characteristics of pseudopolyps.
Dimitrios S Politis, Konstantinos H Katsanos, Epameinondas V Tsianos, Dimitrios K Christodoulou, Department of Gastroenterology, University Hospital of Ioannina, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
Dimitrios S
DS
Politis
Dimitrios S Politis, Konstantinos H Katsanos, Epameinondas V Tsianos, Dimitrios K Christodoulou, Department of Gastroenterology, University Hospital of Ioannina, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
Konstantinos H
KH
Katsanos
Dimitrios S Politis, Konstantinos H Katsanos, Epameinondas V Tsianos, Dimitrios K Christodoulou, Department of Gastroenterology, University Hospital of Ioannina, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
Epameinondas V
EV
Tsianos
Dimitrios S Politis, Konstantinos H Katsanos, Epameinondas V Tsianos, Dimitrios K Christodoulou, Department of Gastroenterology, University Hospital of Ioannina, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
Dimitrios K
DK
Christodoulou
D003093:Colitis, Ulcerative / Q000150:complications / Q000473:pathology*; D003106:Colon / Q000473:pathology; D015179:Colorectal Neoplasms / Q000473:pathology; D003424:Crohn Disease / Q000150:complications / Q000473:pathology*; D004724:Endoscopy / Q000009:adverse effects; D005762:Gastroenterology; D006801:Humans; D007249:Inflammation / Q000473:pathology; D011127:Polyps / Q000473:pathology*
Classification; Crohn's disease; Dysplasia-associated mass or lesion; Giant pseudopolyps; Inflammatory bowel disease; Inflammatory polyps; Post-inflammatory polyps; Pseudopolyps; Ulcerative colitis