‘DESCENDING COLONIC POLYP’- An ultrasound diagnosis

A boy of about 10 yrs age , having h/o bleeding per rectum and occasional pain left lower abdomen, was examined with high resolution color doppler ultrasound, showed-a well defined round to oval iso to hypoechoic solid mass within lumen of descending colon. The mass appeared bulging within lumen with echogenic mucosal stripe over it , & displacing muscularis propria ,suggesting mucosal or submucosal location [ fig 1& 2]. It also showed few tiny cystic areas in it ,which appeared spokewheel like vasculature on color doppler [see fig 3&4]. Vascular signals are seen within lesion on both color & spectral doppler .No any other abnormality was noted in descending colon wall & rest of the abdomen. On the basis of high resolution ultrasound & color doppler findings a diagnosis of benign intraluminal ‘mucosal-submucosal descending colonic polyp’ was made , which subsequently proved on colonoscopy [ see fig 5] , & resected endoscopically. Biopsy turned out to be benign hypertrophic colonic polyp. By- Dr. Subhash Tailor, MD, Bhilwara [ Rajasthan , India]

Fig 1- LS US scan left lower abdomen  showing round to oval hypoechoic intraluminal mass in descending colon with tiny cystic areas in it .

Fig 2- TS US scan showing same mass in descending colon lumen

Fig 3- Color doppler image showing spoke wheel like vasculature within mass

Fig 4- Spectral doppler image of the mass showing both arterial & venous vascular signals 

Fig 5-  Colonoscopic view depicting intraluminal mucosal polyp in descending colon [Image -courtsey Dr. Mukesh Kalla ,gastroenterologist, Jaipur]