Surgical Management of Multiple Polyposis

Abstract

Multiple polyposis of the large bowel was probably recognized clinically as early as 1721 by Menzel.¹ An increasing awareness of the nature of this disease evolved in the late 1800's and the early years of this century, culminating in the lucid descriptions of hereditary pattern, clinical presentation, and malignant potentiality by Lockhart-Mummery² and Dukes.³ Multiple polyposis is a familial disease transmitted as a mendeliandominant characteristic with a high degree of penetrance. Polyps are usually not detected until puberty. These lesions are adenomatous and are distinguishable histologically from the hamartomas of Peutz-Jeghers syndrome and the cystic lesions of juvenile polyposis. Frequently, there may be other associated benign neoplasms such as fibromas, osteomas, and desmoid tumors as in Gardner's and other syndromes. The disease generally is not symptomatic until early adulthood and may then be manifested by diarrhea and hematochezia. If untreated, most patients (perhaps all) will have one