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Abstract: A 58-year-old male patient presented to our hospital with intermittent abdominal pain, blood in the stool, constipation, and dyspareunia. The results of a barium meal intestinal X-ray revealed a mass of adenomatous polyp in the sigmoid colon, which is usually a redundant organism on the surface of the intestinal mucosa, mostly caused by limited hyperplasia of the glandular epithelium. The patient’s condition gradually improved and his symptoms disappeared after electrocoagulation removal with a trap and anti-infection with ceftazidime injection.
Basic information】Male, 58 years old
Disease Type】Adenomatous polyp
Hospital】The First Affiliated Hospital of Kunming Medical University
Date of consultation】February 2021
Treatment plan】Surgical treatment (trap electrocoagulation removal) + medication (ceftazidime for injection)
Treatment period】2 days of hospitalization
Treatment effect】The patient’s prognosis is good, and the symptoms disappeared.
I. Initial consultation
The patient, a 58-year-old male, was referred to our department for examination and treatment by the emergency department. The patient was lying on the hospital bed, curled up, pressing his abdomen with both hands, frowning, with a red face, and shouting from time to time that his stomach was in pain. The patient’s family explained to me that the patient had occasional stomach pain and occasional blood in the stool 2 months ago, and at first thought it was hemorrhoids, so I didn’t pay much attention to it. The patient had no history of hypertension or diabetes mellitus and mildly elevated leukocytes in serological examination, and was found to have a mass in the sigmoid colon by intestinal X-ray barium meal angiography.
II. Treatment process
After barium meal X-ray, a mass was found in the lower part of the sigmoid colon, and then CT examination was performed, which showed a polyp-like enhanced mass protruding from the lumen of the sigmoid colon near the rectum, suspected to originate from the mesenteric border, without transmural extension, and slightly enhanced peri-colonic lymph nodes, but without iliac lymph node enlargement. Therefore, the patient and the patient’s family were informed that although the lesion itself was benign, if the possibility of malignancy was not ruled out by surgical treatment, the recovery process might be affected. Therefore, the final decision was made to remove the mass through colonoscopy using electrocoagulation with a trap, and the mass was sent to the pathology department for examination, which showed that the tissue was a polyp, thus confirming the diagnosis of adenomatous polyp in the sigmoid colon. After the operation, the patient was given ceftazidime for injection to prevent infection.
III. Treatment results
The patient’s symptoms of adenomatous polyp in sigmoid colon were mild and lacked specificity, thus delaying some treatment time. However, since the patient’s adenomatous polyp was benign and slow-growing, the treatment effect of trap electrocoagulation removal was very good, and the patient’s symptoms were significantly relieved after the operation, and the abdominal pain, abdominal distension and blood in the stool basically disappeared. The incision site healed well after the operation without bleeding or infection, and the patient was discharged after 2 days of hospitalization.
IV. Notes
We are glad that the patient’s condition has improved, but we still need to advise the patient to try to have a review within 1 month after discharge, and if any abdominal discomfort occurs during the follow-up period, he should immediately consult the doctor for examination to prevent the recurrence of the disease and avoid delaying the diagnosis and treatment of the disease again. Since the patient has undergone intestinal surgery, it is recommended that the patient be discharged from the hospital with a liquid diet first, and then change to a semi-liquid or soft diet after the gastrointestinal function is stabilized, and then gradually resume a normal diet. In terms of diet, pay attention to a light diet, do not eat cold, spicy and other stimulating food, do not drink alcohol, do not smoke, food with high protein, and also pay attention to vitamin and trace element supplementation.
V. Personal insight
The symptoms of adenomatous polyps often lack specificity and are easily confused with other gastrointestinal diseases, so attention should be paid to differential diagnosis during diagnosis. As in the patient in this paper, the symptoms of adenomatous polyps are mostly abdominal pain, bloating, nausea, vomiting, blood in stool, constipation, etc., which are very similar to those of intestinal entrapment, intestinal torsion and even hemorrhoids, so the diagnosis should be clarified by various tests.
The cause of adenomatous polyps is unknown, but it is likely to be related to poor lifestyle, so patients should pay attention to a healthy diet, advocate a low oil, low salt and low sugar diet, and try to drink less or no alcohol.