Fleecy adenoma

Description:

Fleecy adenoma (papilloma, ferruterous and fleecy polyp) — the benign tumor reminding a cauliflower, very soft consistence quite often reaches the big sizes and tsirkulyarno covers a gut gleam.
The tumor differs from the tubular adenoma described above, the look and clinical manifestations. Fleecy adenoma usually has no leg, sits on the wide basis, on structure reminds a lobular sponge and bleeds at the slightest touch. Sometimes the fleecy tumor has no sharply outlined form, it as if creeps away on a mucosal surface of a cover of a large intestine.

Reasons of fleecy adenoma:

By numerous works it is proved that tubular and fleecy adenomas have the general morphogenesis, and over time tubular adenoma regenerates in fleecy.
In 80% of cases the fleecy tumor is located in a rectum, in 8% — in a distal part of a sigmoid colon, in 3,6% — in cross colonic, in 1,8% — in the ascending colon and in 3,6% — in a caecum.
Fleecy adenomas differ from other tumors of intestines in the fact that cosecrete a large amount of water and electrolytes in a gut gleam. Daily loss of Na * reaches 100 — 160 mmol (it is normal of 2 — 5 mmol), K+ — 25 — 80 mmol (norm of 10 — 15 mmol) and water — 1,5 — 2 l (norm of 100 — 200 ml).
Fleecy adenomas considerably Malignizirutsya more often than adenomatous.

Symptoms of fleecy adenoma:

At most of patients a frequent liquid chair with slime, sometimes with blood, decrease in body weight and iron scarce anemia are observed. Abdominal pains appear if fleecy adenoma causes disturbance of passability of intestines. A characteristic symptom of fleecy adenomas are, in addition to bloody, plentiful mucous allocations.

Diagnosis:

Diagnosis of tumors is carried out by means of a kolonoskopiya and at X-ray inspection. The last can be not informative since the soft fleecy tumor easily becomes impregnated with baric weight and at insufficiently qualified research can be not found. Therefore when at the patient vitreous slime is emitted in large numbers, it is necessary to repeat 1,5 — 2 months later X-ray inspection of a large intestine, having paid special attention of the radiologist to probability of fleecy adenoma.
Therefore for diagnosis of fleecy adenoma of a colon the kolonoskopiya with a multiple biopsy has major importance.

Point changes of an external form of polyps, emergence of ulcerations, fibrous and necrotic imposings to a possibility of a malignancy. Deformation of a gleam of a gut, the fixed bends, badly finishing narrowing of a gleam in combination with the increased vulnerability and contact bleeding force to take material for a histologic research from these departments and to fix attention of clinical physicians to a possibility of a malignancy in this site of a gut.

Treatment of fleecy adenoma:

Fleecy adenomas without signs of a malignancy delete via the endoscope. If at the subsequent histologic research of a remote tumor reveal malignancy signs, especially in the adenoma basis, about make a resection of a large intestine. Big tumors which cannot be subjected to endoscopic electroscission I am daring ют in the surgical way.
When excise a big sedentary polyp, it is recommended to make marking of the place where there was a polyp. Shatz of VA. and соавт. (1997) apply special sterile ink which injects with the help, a special catheter with a needle. The spot which is formed on a serous surface of a gut easily can be revealed further the surgeon.
Forecast. After removal of a fleecy tumor there occurs recovery, control endoscopic inspections have to be performed in 3 months after operation and then at least 1 time a year.