DISPLASTIČNI REKTALNI POLIP NISKOG STEPANA

Keywords: tubulovilozni adenom, način života, krvarenje, karcinom

Abstract


Vilozni adenom je nekancerozna izraslina u debelom crevu. Razvija se iz ćelija koje prekrivaju unutrašnju površinu debelog creva. Ovi adenomi mogu se razviti bilo gde duž debelog creva, od cekuma do rektuma. Svi vilozni adenomi povezani su sa povećanim rizikom od razvoja vrste raka debelog creva, tzv.adenokarcinoma tokom vremena. Polipi mogu biti sesilni ili na peteljci, te variraju veličinom. Incidencija polipa iznosi 7% – 50%; veća incidencija odnosi se na vrlo male polipe (koji su obično hiperplastični ili adenomi), te se nađu kao slučajan nalaz na obdukciji.

Pacijent K. D. starosti 72 godine, ženskog pola, dolazi zbog krvarenja pri defekaciji, kao i zbog promene koja „ispada” iz anusa pri defekaciji, veličine jabuke. Za ovu promenu zna više od godinu dana. U poslednjih nekoliko nedelja promena krvari. Pacijentkinja je koristila čepiće, ali nije došlo do promena u lokalnom nalazu. Uradila je kolonoskopiju, gde je viđena sluznica bledoružičaste boje, urednog nalaza, osim na 3 cm – 4 cm, gde se uočava karfiolasta promena na peteljci, delom prekrivena fibrinskim naslagama, hiperemična.

Prema podacima, kombinovani rizik od displazije/maligniteta je oko 83%, sa 50% rizikom od displazije i otvorenog maligniteta u 33% slučajeva džinovskih rektalnih viloznih adenoma većih od 8 cm.

References

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Published
2023/04/11
Issue
Vol. 62 No. 1 (2023): Acta medica Medianae
Section
Case report