How are adenomatous appearing polyps managed in Crohns disease

How are adenomatous appearing polyps managed in patients with UC and Crohn’s disease? 

  • Adenomatous-appearing polyps should be completely removed by polypectomy, and biopsy specimens should be obtained from the adjacent flat mucosa to determine the presence of dysplasia.
  • If no dysplasia or inflammation is found in the surrounding mucosa, then this can be managed as a sporadic adenomatous polyp.
  • Colectomy is indicated if dysplasia is identified in an area of active inflammation, also known as dysplasia-associated lesion or mass, and there is evidence of dysplasia in the adjacent mucosa.
  • Repeat colonoscopy in 3 to 6 months and close follow-up are warranted when indefinite dysplasia is detected.
  • Mucosal tattooing often assists in identifying the area in question on subsequent endoscopies.
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