Colon Polyp Causing Intussusception, Bleeding, or Suspected of Malignancy — When Is Intervention Indicated?

Non-neoplastic colorectal polyps are common and often managed conservatively. However, when a polyp becomes symptomatic — causing gastrointestinal bleeding, triggering intussusception, or raising concern for malignant transformation — the clinical approach changes decisively.

Clinical Scenario This protocol addresses non-neoplastic colorectal polyps that are causing active bleeding, causing intussusception, or are suspected of being cancer. While most non-neoplastic colorectal polyps are not indicated for endoscopic removal, symptomatic polyps in these specific situations require a different management pathway.

Treatment Approach (partial) The structured protocol involves a resection strategy — either endoscopic or surgical — targeting the symptomatic polyp. The full protocol specifies the criteria guiding the choice between approaches and the complete clinical algorithm. Full regimen and decision criteria available via the link below…

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References

While most non-neoplastic colorectal polyps are not indicated for endoscopic removal, we recommend removal of symptomatic polyps if they are a source of bleeding, cause intussusception, or are suspected of being cancer (recommendation strong [agreement rate 100%], level of evidence D).

However, endoscopic or surgical resection is indicated for polyps that cause clinical symptoms, such as bleeding or intussusception, and those with presumably malignant transformation.

DOI: 10.1007/s00535-021-01776-1

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