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Friends of Endoscopy is all about pattern recognition.  See it today and recognise it tomorrow!   Learn from a New Case on most weekdays !!! 
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Abort or Attack?

30/6/2021

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Picture
This patient with ulcerative colitis has developed a polyp in the transverse colon. The lesion has now been sent for an endoscopic resection.
WHAT WOULD YOU DO?
a) Abort!
Smart!
b) Attack!
You are creating a problem of your own making!
explanation
Some would say; "if you can remove the lesion in that colitic colon, then 'do it'!  The problem is that nothing may appear "irresectable" giving plenty of time, determination and poor judgement. 

Many studies looking at outcomes of polypectomy in UC, excluded polyps >1-2cm or flat polyps.  Other studies have included polyps arising outside of the colitic field or only have a short follow up period of a few years.

Actually, most are coming to believe that when dysplasia develops in the colitic colon, it's not a 'random' case of bad luck. It can be the result of a long process of progressive DNA damage!  At some stage we will be able to have a look at the state of the stem cell DNA in patients with conditions such as Barrett's, Colitis and atrophic gastritis.  I think that we are in for a surprise !

In addition, did you spot the small focus of invasive cancer in the 2-3 O'clock position?  Surprisingly, this was only T1 disease!
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    Categories

    All
    Barrett's
    Cancer
    Cancer Syndromes
    Colitis
    Colorectum
    Corrosive Ingestion
    Crypt Pattern
    Difficulty: Hard
    Difficulty: Moderate
    Difficulty: Very Hard
    Duodenum
    Eosinophilic Oesophagitis
    EUS
    Foveolar Metaplasia
    Gastric
    Gastroscopy
    GI Bleeding
    Histology
    HPB
    Ileum
    Immunosuppression
    Infection
    Local Recurrence Of Barrett's Ca.
    Lymphoma
    Mixed Polyp
    Mucosal Prolapse Syndrome
    NET
    Non-lifting Sign
    Oesophagus
    Opinion Piece!
    Pharynx
    Polyp
    Polypectomy
    The Basics
    TSA

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