Autopolypectomy

A 50-year-old man with a negative medical history except obesity visited the Emergency Unit because of acute anal blood loss, lower abdominal pain, constipation and a collapse. He mentioned the anal expulsion of a ‘meat chunck' prior to the bleeding episode. He carried a glass jar with the collected specimen, which measured 5 X 4 X 2 cm and had a pink-yellowish colour (Figure 1). On physical examination he was hemodynamically stable (blood pressure 150/95 mmHg, heart rate 85 beats per minute), with no signs of anaemia neither abdominal tenderness. Rectal toucher showed dark, old blood. He was admitted and treated with intravenous tranexamic acid while being prepared for colonoscopy. His hemoglobin levels decreased from 9.1 to 8.1 mmol/l (8.5-11.0) in the first eight hours after admission, with mild leukocytosis (12.1/nL). Colonoscopy showed an ulcerated residual stalk of approximately two centimeters in the sigmoid colon (Figure 3). Histopathological examination of the specimen collected by the patient showed only benign adipocytes, in accordance with a giant lipoma (Figure 2).