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A Case of Esophageal Fibrovascular Polyp That Induced Asphyxia during Sleep.

Park JS, Bang BW, Shin J, Kwon KS, Kim HG, Shin YW, Choi SJ - Clin Endosc (2014)

Bottom Line: However, a long pedunculated polyp can regurgitate into the pharynx or oral cavity and cause asphyxia and sudden death if the larynx is occluded.We describe the case of a 51-year-old man who experienced snoring and occasional asphyxia during sleep.Three months after the excision of the polyp, the patient was found to be doing well without any further occurrence of asphyxia or sleep disturbances.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.

ABSTRACT
Esophageal fibrovascular polyps are rare, benign, submucosal tumors of the upper digestive tract that usually have an indolent course until the lesion attains a very large size. The most frequent complaints associated with these tumors include dysphagia and foreign body sensation. However, a long pedunculated polyp can regurgitate into the pharynx or oral cavity and cause asphyxia and sudden death if the larynx is occluded. We describe the case of a 51-year-old man who experienced snoring and occasional asphyxia during sleep. Upper endoscopy was performed, which indicated the presence of a pedunculated esophageal polyp that regurgitated into the vocal cords. The polyp was removed using a polypectomy snare and was confirmed to be a fibrovascular polyp based on pathologic examination findings. Three months after the excision of the polyp, the patient was found to be doing well without any further occurrence of asphyxia or sleep disturbances.

No MeSH data available.


Related in: MedlinePlus

Histopathological features of the fibrovascular polyp. The core of the polyp is composed of dilated blood vessels and fibrous connective tissue covered by squamous epithelium with acanthosis (H&E stain, ×40).
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Figure 2: Histopathological features of the fibrovascular polyp. The core of the polyp is composed of dilated blood vessels and fibrous connective tissue covered by squamous epithelium with acanthosis (H&E stain, ×40).

Mentions: Endoscopy revealed a pedunculated polyp, >5 cm in length, that was detected immediately after inserting the endoscope into the patient's throat (Fig. 1A). The polyp arose from just below the pyriform sinus and regurgitated into the oral cavity during endoscopy. Occasionally, the polyp passed through the vocal cords (Fig. 1B) and obstructed the airway (Fig. 1C). We removed the polyp endoscopically using a polypectomy snare (Fig. 1D) because we believed that the polyp could induce asphyxia during sleep. Histopathological examination indicated that the polypoid lesion contained vascularized loose fibrous shafts covered by squamous epithelium with acanthosis, which were indicative of an FVP (Fig. 2). The patient was discharged on the next day without any complications. At the 3-month follow-up examination, the patient was found to be doing well without any further occurrence of snoring or sleep disturbances.


A Case of Esophageal Fibrovascular Polyp That Induced Asphyxia during Sleep.

Park JS, Bang BW, Shin J, Kwon KS, Kim HG, Shin YW, Choi SJ - Clin Endosc (2014)

Histopathological features of the fibrovascular polyp. The core of the polyp is composed of dilated blood vessels and fibrous connective tissue covered by squamous epithelium with acanthosis (H&E stain, ×40).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3928480&req=5

Figure 2: Histopathological features of the fibrovascular polyp. The core of the polyp is composed of dilated blood vessels and fibrous connective tissue covered by squamous epithelium with acanthosis (H&E stain, ×40).
Mentions: Endoscopy revealed a pedunculated polyp, >5 cm in length, that was detected immediately after inserting the endoscope into the patient's throat (Fig. 1A). The polyp arose from just below the pyriform sinus and regurgitated into the oral cavity during endoscopy. Occasionally, the polyp passed through the vocal cords (Fig. 1B) and obstructed the airway (Fig. 1C). We removed the polyp endoscopically using a polypectomy snare (Fig. 1D) because we believed that the polyp could induce asphyxia during sleep. Histopathological examination indicated that the polypoid lesion contained vascularized loose fibrous shafts covered by squamous epithelium with acanthosis, which were indicative of an FVP (Fig. 2). The patient was discharged on the next day without any complications. At the 3-month follow-up examination, the patient was found to be doing well without any further occurrence of snoring or sleep disturbances.

Bottom Line: However, a long pedunculated polyp can regurgitate into the pharynx or oral cavity and cause asphyxia and sudden death if the larynx is occluded.We describe the case of a 51-year-old man who experienced snoring and occasional asphyxia during sleep.Three months after the excision of the polyp, the patient was found to be doing well without any further occurrence of asphyxia or sleep disturbances.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.

ABSTRACT
Esophageal fibrovascular polyps are rare, benign, submucosal tumors of the upper digestive tract that usually have an indolent course until the lesion attains a very large size. The most frequent complaints associated with these tumors include dysphagia and foreign body sensation. However, a long pedunculated polyp can regurgitate into the pharynx or oral cavity and cause asphyxia and sudden death if the larynx is occluded. We describe the case of a 51-year-old man who experienced snoring and occasional asphyxia during sleep. Upper endoscopy was performed, which indicated the presence of a pedunculated esophageal polyp that regurgitated into the vocal cords. The polyp was removed using a polypectomy snare and was confirmed to be a fibrovascular polyp based on pathologic examination findings. Three months after the excision of the polyp, the patient was found to be doing well without any further occurrence of asphyxia or sleep disturbances.

No MeSH data available.


Related in: MedlinePlus