Abstract
Polyps in the stomach and duodenum are frequently found in familial adenomatous polyposis. Cancer arising from some of these polyps may be an important cause of death in patients who have had large bowel resections. This study aims to determine the nature and distribution of foregut polyps in Chinese patients. Twenty-five patients with familial adenomatous polyposis were gastroscoped by a single operator using the end viewing video-endoscopy system. Representative biopsies of normal mucosa or polyps where appropriate were taken from the gastric fundus, antrum and the duodenum. Twenty-five patients were studied. Male=17, female=8. Median age was 32 years (range=17–63 yrs). Nineteen patients were found to have macroscopically visible polyps in the foregut. Ten patients had gastric polyps alone, three patients had duodenal polyps alone whilst six patients had both gastric and duodenal polyps. Twelve, one and three patients had more than 20 polyps in the gastric fundus, antrum and duodenum respectively. Only one patient had polyps which were larger than 10 mm. The commonest polyp in the gastric fundus was the fundic gland polyp whilst hyperplastic and adenomatous polyps were the commonest polyps in the gastric antrum and duodenum respectively. Five patients had adenomatous polyps of which four had duodenal adenomas alone whilst one patient had adenomas in the duodenum, gastric antrum and fundus. Seventy-six per cent of our patients with familial adenomatous polyposis had foregut polyposis. Adenomatous polyps were found in 56% of patients with duodenal polyps or 20% of patients with foregut polyps but hyperplastic and hamartomatous polyps occur commonly in patients with familial adenomatous polyposis as well.
Résumé
Des polypes gastriques et duodénaux sont fréquemment rencontrés au cours de la polypose adénomateuse familiale. La transformation cancéreuse de ces polypes peut être une importante cause de décès chez les malades qui ont eu des résections coliques. Le but de cette étude est de déterminer la nature et la distribution des polypes de cette région chez les patients chinois. 25 patients atteints de polypose adénomateuse familiale ont été gastroscopés par un même opérateur utilisant un système de vidéoendoscopie à vue terminale. Des biopsies représentatives de la muqueuse normale ou de polypes existants ont été réalisées au niveau du fundus de l'antre et du duodénum. 25 malades ont été étudiés, 17 hommes, 8 femmes d'un âge moyen de 32 ans (17–63 ans). 19 patients avaient des polypes macroscopiquement visibles dans le tube digestif supérieur. 10 malades avaient des polypes gastriques seuls, 3 avaient des polypes duodénaux seuls tandis que 6 avaient à la fois des polypes gastriques et duodénaux. 12, 1 et 3 patients avaient plus de 20 polypes dans le fundus, l'antre ou le duodénum respectivement. 1 seul malade avait des polypes d'un diamètre supérieur à 10 mm. Le type le plus common de polype du fundus était un polype des glandes fundiques tandis que des polypes hyperplasiques et adénomateux étaient les polypes les plus communs dans l'antre et dans le duodénum respectivement. 5 malades avaient des polypes adénomateux dont 4 avaient uniquement des adénomes duodénaux tandis que 1 patient avait des adénomes duodénaux, gastriques au niveau de l'antre et du fundus. 76% de nos patients avec une polypose adénomateuse familiale avaient une polypose au niveau du tube digestif supérieur. Les polypes adénomateux ont été trouvés chez 56% des malades avec des polypes duodénaux ou 20% des malades ayant des polypes du tube digestif supérieur mais les polypes hyperplasique et hamartomateux surviennent fréquemment chez les patients qui ont une polypose adénomateuse familiale.
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Seow-Choen, F., Ho, J.M.S., Wong, J. et al. Gross and histological abnormalities of the foregut in familial adenomatous polyposis: A study from a South East Asian Registry. Int J Colorect Dis 7, 177–183 (1992). https://doi.org/10.1007/BF00341216
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DOI: https://doi.org/10.1007/BF00341216