Prolapsing gastric polyp causing intermittent gastric outlet obstruction

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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 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 - Jun 2015
Externally publishedYes

Keywords

  • Gastric obstruction
  • Gastric polyp
  • Surgical management

ASJC Scopus subject areas

  • Surgery

Fingerprint

Dive into the research topics of 'Prolapsing gastric polyp causing intermittent gastric outlet obstruction'. Together they form a unique fingerprint.

Cite this