Ivonne
Going for step 3/99
Topics: 50
Posts: 1,397
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19 yr old male, with two siblings diagnosed with 100's of colon adenomas and having had proctocolectomy at ages 23 and 29. Your patient also undergoes sigmoidoscopy and found to have several dozens of colon polyps 5 of which were biopsied and were benign adenomas. Which of the following is the most appropriate next step in management?
1.repeat sigmoidoscopy in 1 yr
2.colonscopy in 1 yr
3.schedule full colonoscopy.
4.schedule total proctocolectomy
5.Evaluate the proximal colon with barium enema
Explain your answer pz
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| pr20
Forum Senior
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3.schedule full colonoscopy.
Before surgery,full colonoscopy is needed to rule out synchronous second primary.
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| DrS
Forum Elite
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4.schedule total proctocolectomy
Finding several polyps >100 in sgmoidoscopy is diagnostic of FAP, of which definitive treatment is total proctocolectomy
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| cuadrado_g
Forum Senior
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4.
Even if colonos is normal colectomy is next; and if more polyps are found, colectomy again. Colonos dont change the management
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| guangyu
Forum Elite
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why not 3?
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| Miradautas Vras
Forum Senior
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I'd go for total colonoscopy. Surgeon needs to decide the extent of removal needed
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| sherry39
Forum Junior
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4
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| nyimalay
Forum Elite
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Yes. 4. Schedule total proctocolectomy.
Surgical plan for FAP has already been total proctocolectomy. No colon left whatever the finding of colonoscopy.
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| Ivonne
Going for step 3/99
Topics: 50
Posts: 1,397
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The correct answer is 4
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