Filiform polyposis (FP) is a rare entity that is associated with inflammatory bowel disease. It is present in 10-20% of cases, especially in patients with ulcerative colitis, and is characterized by the presence of soft and elongated “worm-like” or “finger-like” polyps that can measure up to 9 cm in length and form mucosal bridges. A 44-year-old man with ulcerative colitis had abdominal pain of 15-day progression and leukocytosis. The computed tomography (CT) scan identified thickening of the descending colon, with atypical morphology, and intraluminal content associated with pneumoperitoneum. Emergency sigmoidectomy and Hartmann procedure were performed, revealing purulent peritonitis secondary to the perforation of a large mass with an inflammatory aspect in the left colon (Fig. 1). The pathology study showed countless digitiform polypoid formations that fused together, constituting bridges (Fig. 2). Histologic study reported acute and chronic inflammation with abscesses, consistent with perforation, and no dysplasia (Fig. 3). A later endoscopic examination showed the presence of filiform polyposis in the remaining colon (Fig. 4). Filiform polyposis should be suspected in patients with ulcerative colitis that present with clinical obstruction. Perforation is a rare complication.
The authors declare that no experiments were conducted on humans or animals for the present article, that they have followed the protocols of their work center on the publication of patient data, and that they have preserved patient confidentiality and anonymity at all times. Informed consent was requested from the patient for the surgical intervention and it included a section stating the possibility of utilizing images or clinical data for scientific purposes.
Financial disclosureNo financial support was received in relation to this article.
Conflict of interestThe authors declare that there is no conflict of interest.
Please cite this article as: Ruiz de la Hermosa A, Burdaspal-Moratilla A, Paseiro-Crespo G. Poliposis filiforme. Complicación infrecuente en un paciente con enfermedad inflamatoria intestinal. Rev Gastroenterol Méx. 2022;87:103–105.