PROLAPSING COLONIC POLYP

This young woman was referred to the surgical receiving team by her general practitioner, with thrombosed prolapsing haemorrhoids.

The patient gave a 2-day history of a mass prolapsing through the anal verge associated with mild perianal pain. She also gave a history of "piles" 4 years previously, which did not require any surgical intervention.

It soon became clear on closer inspection that the mass prolapsing through the rectum was in fact a colonic polyp rather than a thrombosed haemorrhoid. An EUA, colonoscopy and excision of polyp was therefore carried out in theatre.
At colonoscopy the polyp was found to extend on a long stalk to 25cms from the anal verge. Further pathological examination of the polyp showed it to be a lipomatous polyp which had undergone infarction. There were no further findings from the colonoscopy and the patient recovered well from the procedure. A further screening colonoscopy will be carried out in 3 years time.

G MacKay, D Murphy, S Gardiner