Clinical Features of Cap Polyposis Taiji Akamatsu 1 , Naoshi Nakamura 2 , Kazutoshi Kamijo 2 , Eiji Tsugane 2 , Noboru Kamijo 2 1Department of Endoscopy, Shinshu University Hospital 2The Second Department of Internal Medicine, Shinshu University School of Medicine Keyword: cap polyposis , 分類不能型大腸炎 , 粘膜脱症候群 , 炎症性腸疾患 , metronidazole pp.641-650
Published Date 2002/4/25
DOI https://doi.org/10.11477/mf.1403103508
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 Cap polyposis is an inflammatory bowel disease, which was firstly reported by Williams et al. in 1985. This rare disease has characteristic clinical, endoscopic and pathological features. The etiology of this disease is still unknown, but chronic mechanical stimulation by abnormal colonic motility may play an important role in its pathogenesis. We studied 20 reported cases and our 5 cases. The patients' ages ranged from 20 to 76 years, with an average of 48.0. The sex ratio was 6 men to 19 women. The most common symptoms were mucous diarrhea or mucous bloody stool. Laboratory data showed hypoproteinemia due to protein loss from the lesions in most cases, and markers of inflammation such as CRP and ESR were usually normal. Typical endoscopic findings revealed multiple sessile inflammatory polyps, which were reddish and attached by mucous in the rectum and the sigmoid colon. Multiple white specks were often observed surrounding the lesions, but the intervening mucoua was generally normal. On the other hand, these typical endoscopic findings were sometimes not recognized in the initial or improved phase. 5-aminosalicylic acid agents and steroid hormone were usually not effecitive, but metronidazole was effective in some cases. Surgical resection and endoscopic therapy reduced symptoms temporally, but recurrences were recognized within 12 months in many cases. Treatment by avoidance of intraluminal trauma such as straining at defecation was successful in some cases.

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