Polyps

Polyps of large intestine benign tumors, representing a growth of glandular epithelium in the form of a mushroom, sometimes branchy education on the mucous membrane. The colon polyps may be solitary, group and multiple. The polyps are quite varied - from very small (with millet grain or seed cherry) to the value of the forest or even walnut. Polyps associated with the wall of the intestine through the legs (sometimes reaching lengths 1,5-2 cm) or broad base.
For group polyposis in a small area direct or colon cancer is a group of polyps. They are generally small in size (maximum of 0.5 cm in diameter) and usually have short legs. The mucous membrane is at rest during bowel not changed.
Multiple polyps, or diffuse polyposis,is an independent disease, where all the mucosa of the large intestine is covered polyps of various sizes and forms, sometimes in such quantity that literally has no plot healthy mucosa.
Colon polyps are detected at any age, including young children.
Cause polyps unknown. There are assumptions on the viral nature of this disease. Practice shows that they are often found in people with low acidity gastric juice in patients with chronic colitis, particularly after heavy shigellosis (bacillary or amoebic).
Polyps in its histological structure are divided into adenomatous, villous and mixed.
Adenoma - the most common form of polyps of the colon. It is a solid education rounded, smooth, without ulceration; mucous membrane that covers the polyp, as well as in General mucous membrane ulcers that are not changed, has a pink color and normal vascular pattern.
A special form of polyp - villous tumor is different from adenomatous the fact that it usually has no legs, sitting on a broad basis and as it floats on the surface of the mucous membrane. The structure resembles lobed sponge and bleeds at the slightest touch.
It should be noted another type of polyp, growing in the anal canal - fibrous polyp on the leg. It consists mainly of connective tissue and often develops from the hemorrhoid. Sometimes anal polyp reach large sizes and are easily detected when urinating when I roll into the anal opening.
On the mucous membrane of the colon meet, in addition to the above true polyps, pseudoprime. They arise due to chronic inflammation (chronic colitis, proktoshigmoidit) and are located on the background of inflamed mucous membranes in the form of small hills. Pseudoprime not have legs, bleed easily, and may disappear under the influence of the treatment of the underlying disease.
The clinical picture of polyps is depending on their number, location, size, histological structure, and also from, whether they have the leg or are on a broad basis.
The most characteristic symptom of the polyp is bleeding. It shows through in the form of strips of blood on the surface of feces, usually in cases where the polyp is located in the lower intestine (direct or sigmoid colon).
In clinical practice, there are difficulties in establishing the causes of gastrointestinal bleeding in children younger and middle age. Have to face the facts when the child bleeding is the manifestation of chronic dysentery or ulcerative colitis. Baby for a long time subjected to different types of treatment, while the real cause of the bleeding is juvenile polyps of the colon.
When the colon polyps can be observed mucous or blood-tinged-mucus occurring continuously in this form polyp, as villous tumor. Given that this symptom is usually interpreted as one of the manifestations of chronic colitis, in each case, you should resort to special methods of investigation of the colon (endoscopic, x-ray), allowing to make the correct diagnosis.
The function of the intestine with the polyp (if not other diseases) is not violated, and only when the polyp reach large sizes, can develop constipation or, on the contrary, due to irritation - tenesmus and diarrhea.
The colon polyps may not have any clinical symptoms and discovered accidentally during examination of the patient.
It is important to emphasize that the symptoms polyps of the colon are not specific and occur in other diseases of the gastrointestinal tract (gastric ulcer or duodenal ulcer, chronic cholecystitis, chronic enterocolitis and others). From here there are difficulties early clinical diagnosis of colon polyps in patients with pathology of organs of digestion, since in these cases it is characteristic of intestinal polyps symptoms can be shaded symptoms of other diseases of the gastrointestinal tract.
Of crucial importance in the diagnosis of polyps of the colon belongs objective research methods. These include digital examination of the rectum, anoscopy, sigmoidoscopy, colonoscopy, x-ray examination of the colon and morphological methods (histology and Cytology).
More details about the biopsy. In most cases, when a polyp on the leg has a smooth surface, without any subsequent to resort to biopsy is not necessary. Moreover, biopsy normal glandular polyps are fraught with the danger of bleeding. In addition, the polyp still want to delete, and then subjected to detailed histological examination.
It's more complicated with so-called villous polyps (especially when they reach large sizes). Even small villous tumor, sitting on a broad basis, easy-to-injure and bleeding, not always easy to distinguish from cancer. In such cases, before deciding on a method of therapy is necessary to clarify the nature of the polyp, which produce a biopsy (with base tumors).


Electrocoagulation of polyps is as follows. The patient, prepared as for rectoromanoscopy (regular cleansing enema the night before and for 2 hours before surgery), is set in the knee-elbow position. In the rectum is entered rectoromanoscopy.
Electrocoagulation is a device for surgical diathermy. Electrode lead - plate - wrapped with four layers of moist gauze and strengthened on the back. During electrocautery assistant should ensure that the record was tight all surface pressed to the skin, otherwise the patient will feel her prijigatm action can occur even burns).
The surgeon in dry rubber gloves enters through rectoromanoscopy tongs type bronchoscopic (or through bioptic channel of the colonoscope loop), captures their leg polyp, as close to its base. When the spoon will be closed down, or the loop will be delayed, to arm forceps brought the tip of the device for surgical diathermy. Operating sister signal surgeon includes current.
The moment electrocautery takes a maximum of 2 C. During this time should happen charring legs, sandwiched between the cups. The surgeon then careful jerks jerk polyp. If the surgeon feels that charring not occurred, he shall not apply force, and repeat the process electrocautery.
Usually when properly electrocautery after removing the polyp on the stalk remains burned surface area the size of 1x1, see the visible place of removal legs or its remainder, which prisosalsya advanced.
If a polyp is very large, and a leg missing, have to produce its destruction in parts (especially when there is considerable in size villous tumor). Sometimes after removal of a polyp in parts of a large burned surface, and therefore have to carry out the operation in several stages, at intervals of 2-3 weeks.
Depending on the localization of the polyp, its size, character and structure machinery electrocautery can be quite simple and very complex. It largely determines the postoperative period and appointed after the operation mode.
If the polyp was located in the lower part of the rectum, had a leg and the size of the burn surface after removing it was about 1X1 cm, the patient is recommended bed rest for a maximum of three days. The delay of a chair specifically to make not necessary. But the food should not be annoying.
After electrocautery large polyps, located high in the colon and above, bed rest is recommended during the 5-7-11 days.
Once again I want to emphasize that the detection and removal of polyps in itself is the prevention of cancer. This raises the question about the need for medical examination and screening of all patients with any violations of the digestive tract, for the detection and timely treatment of polyps.