[Correlation of Barrett's esophagus and colonic adenomas].

INTRODUCTION

According to the case-control studies, colon adenomas are not more frequent as usual in patients with Barrett's oesophagus.

AIM: Analysis of the relationship of Barrett's oesophagus with colon adenomas through a case presentation.

METHOD: The 62-years old male patient has been treated with pantoprazole for reflux oesophagitis and histologically proven short-segment Barrett's oesophagus. Pantoprazole treatment was started and the patient became symptom-free. In 1997 colonoscopy was performed for rectal bleeding and 4 recto-sigmoideal polyps were removed (tubular adenomas). After 4 years of PPI treatment, laparoscopic fundoplication was performed but after one year of symptom-free period, PPI was started again because of relapse. The patient was followed-up for 5 years. The histological examinations included also Ki67 and p53 antibody staining.

RESULTS

On control colonoscopies, small rectal and sigmoid polyps were found. The retrospective histologic examination of the polyps revealed the increase of Ki-67-positive cells from 2-5% to 45-55% during the 5 years of follow-up, which is higher than the values found in controls and may express the increasing proliferative activity of the epithelium.

CONCLUSION

Although according to the literature, Barrett's oesophagus does not increase the risk of colon adenomas, this may occur in individual cases, warranting close follow-up.