gastric polyp
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Etiology
- sporadic
- proton pump inhibitors[5]
- generally < 10 polyps
- proton pump inhibitors[5]
- familial adenomatous polyposis coli
Pathology
- gastric fundic gland polyps
- most common form of gastric polyp
- small, often multiple
- if sporadic, no defined risk of cancer
- gastric adenoma
- hyperplastic polyp
Laboratory
- APC gene mutation
- indicated for dysplastic polyps, adenomas, or family history of colorectal cancer[1]
Diagnostic procedures
- upper GI endoscopy with polypectomy for diagnosis
- no follow-up upper GI endoscopy indicated for fundic gland polyps without dysplasia[1]
- colonoscopy for familial adenomatous polyposis coli
- > 10 polyps
- > 40 years of age[1]
- indicated regardless of APC gene mutation status[1]
Complications
- some gastric polyps (adenomas & hyperplastic polyps) have malignant potential[2]
Management
- polypectomy of fundic gland polyps not routinely indicated unless > 1 cm[1]
- endoscopic resection of large polyps (> 1 cm) & gastric adenomas[1]
- reassurance for small (< 1 cm) fundic gland polyps without dysplasia
Notes
- literature base is relatively weak
- any recommendations must be viewed in light of this[2]
More general terms
References
- ↑ Jump up to: 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 2009, 2012, 2015, 2018, 2021.
- ↑ Jump up to: 2.0 2.1 2.2 Goddard AF, Badreldin R, Pritchard DM et al The management of gastric polyps. Gut. 2010 Sep;59(9):1270-6 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20675692
- ↑ Park do Y, Lauwers GY. Gastric polyps: classification and management. Arch Pathol Lab Med. 2008 Apr;132(4):633-40 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18384215
- ↑ Shaib YH, Rugge M, Graham DY, Genta RM Management of gastric polyps: an endoscopy-based approach. Clin Gastroenterol Hepatol. 2013 Nov;11(11):1374-84 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23583466
- ↑ Jump up to: 5.0 5.1 Martin FC et al. Systematic review with meta-analysis: Fundic gland polyps and proton pump inhibitors. Aliment Pharmacol Ther 2016 Sep 15 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27634363