At the focal point| Volume 87, ISSUE 5, P1354-1355, May 2018

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Natural polypectomy of a gastric polyp

Published:November 01, 2017DOI:
      A 73-year-old woman was admitted to the hospital for a gastric polypectomy. Nine months earlier, she had visited the hospital because of abdominal discomfort. At that time, upper endoscopy showed a 1.8-cm pedunculated polyp on the lesser curvature of the prepyloric antrum (A). A biopsy specimen was obtained, and it was diagnosed as a hyperplastic polyp. The patient was recommended for endoscopic polypectomy, but she decided to defer the procedure to a later date. Before revisiting the hospital for the polypectomy, the patient experienced melena and abdominal pain for several days. Additionally, before experiencing melena, she had a history of using nonsteroidal anti-inflammatory drugs (NSAIDs) for back pain. Upon revisit, upper endoscopy revealed that the pedunculated polyp previously located on the prepyloric antrum had disappeared, and a small active ulcer had formed at the same site (B). The ulcer was confirmed as benign, both endoscopically and histologically. For treatment of the ulcer, the patient was prescribed a proton-pump inhibitor for 2 months. In this case, owing to the location and morphology of the polyp, the pedunculated polyp on the antrum was likely to undergo traction mechanically and torsion by peristalsis. Additionally, ulcerogenic medications such as NSAIDs may also play a role in autoamputation.
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