Abstract
BackgroundCap polyposis (CP) is extremely rare in Japan, and there is no established cure. We report a case in which CP was improved by surgical treatment.Case presentationA 48-year-old man was investigated at a local hospital because of diarrhea and bloody stools in 2018. The patient was treated with metronidazole for suspected amoebic dysentery, but his symptoms did not improve. Subsequent close examination revealed possible CP, but treatment with 5-aminosalicylic acid and a steroid enema had no effect. The patient was then referred to our hospital. The bloody stools, diarrhea, and abdominal pain worsened despite medical treatment, so laparoscopic-assisted total proctocolectomy and ileal J-pouch anal anastomosis with ileostomy were performed. CP has no known cause or established treatment, but Helicobacter pylori (HP) infection has been reported in many CP cases in Japan, and HP eradication is often successful. This patient was HP-negative and did not improve with antimicrobial treatment, but the symptoms improved after surgery.ConclusionsEven after surgery, CP recurrence reportedly occurs within a short period in many cases. However, our patient has had no signs of CP recurrence during 1 year of follow-up.
Highlights
ConclusionsCap polyposis (CP) recurrence reportedly occurs within a short period in many cases
Cap polyposis (CP) is extremely rare in Japan, and there is no established cure
Even after surgery, CP recurrence reportedly occurs within a short period in many cases
Summary
CP recurrence reportedly occurs within a short period in many cases. The patient was started on oral metronidazole (MNZ), but the symptoms did not improve and there were no improvements seen on repeat TCS performed 2 months later. The patient was referred to the Department of Internal Medicine of our hospital for further examination and medical treatment. TCS performed at our hospital revealed reddened mucosa and multiple raised lesions from the middle of the transverse colon to the rectum; these lesions were covered with white moss (Fig. 1). We performed a laparoscopicassisted total proctocolectomy and J-type ileal pouch anal anastomosis (IPAA) with ileostomy (Fig. 2) After the operation, his symptoms rapidly improved, and he started eating on postoperative day 3. There was no recurrence of symptoms or polyps in the ileal pouch, and stoma closure was performed 3 months after surgery. 1 year has passed since the stoma closure, and there has been no recurrence observed
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