Colonic polyps
Alerts and Notices
Synopsis
Histologically, polyps may be tubular, villous, or tubulovillous. Villous adenomas are 3 times more likely to become malignant than tubular polyps. The likelihood that a polyp contains invasive cancer increases with the size of the polyp. Most polyps remain asymptomatic and are detected during routine screening colonoscopy. Less than 5% of polyps lead to bleeding.
Once an adenomatous polyp has been detected, the entire colon should undergo surveillance for polyp detection. Colonoscopy should be repeated based on the number and histology of previously discovered polyps. Family history and certain disease processes (eg, ulcerative colitis, familial adenomatous polyposis) can impact surveillance colonoscopy recommendations as well.
Codes
ICD10CM:K63.5 – Polyp of colon
SNOMEDCT:
68496003 – Polyp of colon
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Peutz-Jeghers syndrome – Intestinal hamartomatous polyps associated with mucocutaneous pigmentation.
- Familial adenomatous polyposis – Inherited as autosomal dominant disorder. Polyps are carcinogenic if left untreated.
- Gardner syndrome – Associated with osteoma in addition to colonic polyposis.
- Turcot syndrome
- Juvenile polyposis syndrome
- Hereditary nonpolyposis colon cancer
- Clostridioides difficile infection with pseudopolyposis
Best Tests
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Management Pearls
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Therapy
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References
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Last Reviewed:04/19/2017
Last Updated:11/01/2022
Last Updated:11/01/2022
Colonic polyps