In small bowel hamartoma, the size of individual polyps and the presence of obstructive symptoms determine when active intervention is warranted. Two distinct thresholds trigger the same clinical decision: polyps exceeding 15–20 mm, and smaller polyps that are already causing symptoms.
The protocol targets symptomatic patients with small-bowel polyps larger than 15–20 mm, or patients with smaller small-bowel polyps that are producing obstructive symptoms. In the first group, the principal concern is preventing intussusception; in the second, the indication arises from the burden of symptoms regardless of polyp size.
Management is centred on an endoscopic route into the small bowel for polyp removal. Whether an additional intraoperative evaluation step is appropriate depends on the individual patient's phenotype. The full protocol specifies which intervention modality applies, the technical decision points, and how the two size-based indications are sequenced — all accessible through the link below.
DOI: 10.3390/jcm10030473