Successful Hot Snare Polypectomy for Sigmoid Polyp in a 55 Y.O. Male with Chronic Constipation

Chief Complaints

A 55-year-old male patient with a body mass index (BMI) of 20 presented to the Gastroenterology Department at PACE Hospitals, Hitech City, Hyderabad, with complaints of intermittent constipation for the past three months, associated with generalized weakness and anorexia (loss of appetite).

The patient had no known comorbidities and no significant past medical or surgical history. There was no history of chronic illnesses such as hypertension, diabetes mellitus, cardiovascular disease, or previous gastrointestinal disorders reported.

On examination, the patient was conscious, coherent, and well-oriented to time, place, and person. He was hemodynamically stable with vital signs within normal limits. Systemic examination revealed a soft and non-tender abdomen with no signs of organomegaly or guarding. Respiratory and cardiovascular examinations were normal, and oxygen saturation was maintained on room air.

Upon admission to PACE Hospitals, following the clinical assessment, the Gastroenterology team conducted a comprehensive evaluation of the patient’s symptoms, including intermittent constipation for three months associated with generalized weakness and anorexia, along with a detailed review of his medical history.

Clinical examination and colonoscopic evaluation revealed sigmoid colon polyp and small internal hemorrhoids. Laboratory investigations, including complete blood picture (CBP) and renal function tests (RFT), were largely within normal limits except for mild anemia and mild thrombocytopenia. There was no evidence of systemic instability, and vital parameters remained stable throughout the evaluation.

Based on the confirmed diagnosis, the patient was advised to undergo Sigmoid Polyp Treatment in Hyderabad, India, under the expert care of the Gastroenterology Department.

After a detailed consultation with consultant gastroenterologists, Dr. Govind Verma, Dr. M. Sudhir, and Dr. Padma Priya, a comprehensive evaluation was performed to determine the most appropriate diagnostic and therapeutic approach.

Considering the patient’s history of on-and-off constipation for 3 months associated with generalized weakness and anorexia, and endoscopic findings suggestive of a sigmoid colon polyp along with small internal hemorrhoids, further evaluation and definitive management were planned. The absence of significant comorbidities and stable clinical parameters supported an endoscopic therapeutic approach.

Based on clinical assessment, colonoscopic findings, and routine laboratory investigations showing mild anemia with otherwise stable hematological parameters, it was determined that sigmoid hot snare polypectomy was identified as the most appropriate and effective management strategy. This approach was chosen to ensure complete removal of the lesion, prevent potential malignant transformation, obtain tissue for histopathological examination, and provide symptom relief with minimal invasiveness and faster recovery compared to surgical alternatives.

The patient and his family members were counselled regarding the diagnosis, endoscopic findings, procedure performed, and the importance of follow-up for histopathology report correlation and further management if required.

Following the decision, the patient was scheduled to undergo Sigmoid Hot Snare Polypectomy Procedure in Hyderabad at PACE Hospitals, under the specialized care of the Gastroenterology Department.

The following steps were carried out during the procedure:

• Colonoscopic Access and Localization: A flexible colonoscope was introduced per rectum and advanced through the large bowel. The sigmoid colon was carefully examined, and the polyp was identified under direct visualization.

• Assessment and Preparation of the Lesion: The sigmoid polyp was evaluated in terms of size, morphology, and attachment. The surrounding mucosa was inspected to ensure safe endoscopic resection.

• Submucosal Injection (Polyp Lifting): The base of the polyp was injected with methylene blue solution into the submucosal layer. This created a lifting effect, separating the lesion from deeper muscular layers and reducing the risk of perforation.

• Hot Snare Polypectomy (Polyp Resection): A wire snare was positioned around the base of the lifted polyp, and electrocautery current was applied. This allowed simultaneous cutting and coagulation, resulting in complete excision of the polyp with effective hemostasis.

• Specimen Retrieval and Procedure Completion: The excised polyp was retrieved and sent for histopathological examination (HPE). The resection site was inspected endoscopically, and no immediate bleeding or complications were observed. The procedure was completed successfully.

Following the procedure, the patient had an uneventful recovery during the hospital stay. He was managed with supportive care, including hydration, infection prevention, gastric mucosal protection, and bowel regulation measures. The patient showed good symptomatic improvement and remained clinically stable throughout admission. He tolerated diet well and had no post-procedural complications. The histopathology report suggested that the polyp was a benign growth (tubular adenoma) with mild abnormal cell changes (low-grade dysplasia). The patient was discharged in a hemodynamically stable condition with advice for follow-up care.

Upon discharge, the patient was prescribed medications for the prevention of post-procedural infection, the reduction of gastric acid secretion to support gastrointestinal mucosal healing, and the maintenance of regular bowel movements to prevent constipation and straining. The management plan was supportive in nature, focusing on post-endoscopic recovery, gastrointestinal protection, and bowel regulation.

The patient was advised to follow a normal diet as tolerated.

The patient was informed to contact the emergency ward at PACE Hospitals in case of any emergency or development of symptoms such as fever, severe abdominal pain, rectal bleeding, vomiting, or passage of black stools.

The patient was advised to return for a follow-up visit with the Gastroenterologist in Hyderabad at PACE Hospitals, after 1 week to review his condition.

This case highlights a sigmoid colon polyp with small internal hemorrhoids identified during evaluation of chronic constipation and associated symptoms. The polyp was successfully removed by colonoscopic hot snare polypectomy without complications. The patient had an uneventful recovery with symptomatic improvement and remained clinically stable. Histopathological examination was advised for further evaluation and confirmation.