Successful endoscopic polypectomy for colonic vascular ectasia presenting as pedunculated polypoid lesion.

frequent cause of lower intestinal bleed− ing in the elderly. Recent advances in co− lonoscopy have discovered colonic vascu− lar ectasia with increasing frequency. Co− lonic vascular ectasia often presents as multiple reddish, slightly elevated, muco− sal lesions. It may be treated at colonos− copy with laser photocoagulation, heat probe, electrocoagulation, and argon plasma coagulation [1 ± 4]. We present a case of an unusual pedunculated poly− poid colonic ectasia that was successfully treated with endoscopic polypectomy. A healthy 69−year−old man underwent colonoscopy because of recent anal dis− comfort and frequent abdominal fullness. Laboratory tests did not reveal anemia or positive fecal blood test. Colonoscopy re− vealed a soft, reddish pedunculated poly− poid lesion, about 2.5 cm in diameter, with superficial ulceration and some bloody exudates at the ascending colon. Endoscopic polypectomy for suspected malignancy was carried out without complication (l" Fig. 1). Histopathologic evaluation of the resection specimen showed edematous submucosa with an obvious dilated vein lined by endothelial cells. Some dilated capillaries were also found in the mucosa (l" Fig. 2). Colonic vascular ectasia was diagnosed. At 1−year follow−up, the patient was uneventful. The typical endoscopic appearance of co− lonic vascular ectasia was often reported to be a slightly elevated reddish mucosal lesion. Pedunculated polypoid morpholo− gy of colonic vascular ectasia is extremely rare. This case suggests that colonic vas− cular ectasia could present as a single, asymptomatic, pedunculated lesion with an ulcerative surface. Furthermore, the lesion can be safely removed by endo− scopic polypectomy with electrocoagula− tion snare.