Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + • Evidence of polyp in the stomach on upper GI endoscopy• May be associated with gastric outlet obstruction if located in the distal stomach +++ Epidemiology + • Hyperplastic polyps (> 80%)-Represent overgrowth of normal epithelium-Not true neoplasms-No relationship to gastric cancer• Adenomatous polyps-30% contain a focus of adenocarcinoma-The incidence of cancer in an adenomatous polyp rises with increasing size; those with a stalk and those < 2 cm are usually not malignant-About 10% of benign adenomatous polyps undergo malignant change during prolonged follow-up-Adenocarcinoma found elsewhere in the stomach in 20% of patients with a benign adenomatous polyp• Polyps located in distal stomach are more apt to cause symptoms• Occur predominantly in the elderly +++ Symptoms and Signs + • Most asymptomatic• Vague epigastric discomfort• Dyspepsia• Occult GI bleeding• Gastric outlet obstruction with nausea and vomiting if polyp is located in the distal stomach +++ Laboratory Findings + • Anemia may develop from chronic blood loss or deficient iron absorption• Over 90% of patients are achlorhydric after maximal stimulation• Vitamin B12 absorption is deficient in 25%, although megaloblastic anemia is present in only a few +++ Imaging Findings + • Upper GI endoscopy: Reveals presence of gastric polyp• Gastric polyp may also be visible on upper GI contrast radiographic study• In all cases, histologic diagnosis is required by endoscopy and polypectomy or biopsy + • Most gastric polyps are discovered incidentally on upper GI radiographic or endoscopic studies +++ Rule Out + • Gastric cancer + • Upper GI endoscopy or contrast radiography will detect the lesion• Endoscopy should be performed in all cases for histologic diagnosis and to exclude cancer• Endoscopy may be diagnostic and therapeutic +++ When to Admit + • High-grade gastric outlet obstruction preventing adequate enteral nutrition• Severe bleeding from polyp +++ Surgery + • Endoscopic removal can be performed successfully in most cases• Laparotomy and gastrotomy if endoscopy is unsuccessful +++ Indications + • Failure of endoscopic polypectomy• Cancer found in polyp• Gastrectomy may be required for multiple polyps +++ Treatment Monitoring + • Surveillance endoscopy for patients with gastric adenomas +++ Complications + • Occult GI bleeding• Gastric outlet obstruction +++ Prognosis + • Recurrent polyps are uncommon +++ References ++Abraham SC et al. Hyperplastic polyps of the stomach: associations with histologic patterns of gastritis and gastric atrophy. Am J Surg Pathol. 2001;25:500. [PubMed: 11257625] Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth