Familial adenomatous polyposis coli: A case report

Abstract

A 25-year-old man was admitted with a 6-month history of rectal bleeding, anal discharge and alteration in bowel habits. He gave a family history of a great grandmother who died of unknown causes but had a colostomy, and a grandmother who died of Carcinoma of the oesophagus. Both relatives were on maternal side. On examination he had a low rectal mass, which was obliterating the anal orifice. Colonoscopy was not possible but rectal biopsy revealed a well-differentiated carcinoma of the rectum. Abdomino- perineal resection was done. During surgery, he was found to have multiple polyps. Colonoscopy through the colostomy and biopsy confirmed the presence of multiple benign polyps involving the entire colon up to the caecum. After counselling, the patient had total colectomy and an ileostomy done. Subsequent screening of family members revealed a 28-yearold sister who had occasional painless rectal bleeding. The 28 year-old sister of the patient above had colonoscopy done and was found to have adenomatous polyps involving most of the colon up to the caecum. A near- total colectomy and ileorectal anastomosis was done and cautery of the rectal polyps. She is being followed up with 6-monthly proctoscopy and is doing well.