Spontaneous Expulsion per Rectum of a Colorectal Polyp: A Ra
Approximately two-thirds of all colorectal polyps are adenomatous precancerous lesions that have the potential to become malignant. Usually, they are discovered and resected during colonoscopy. The spontaneous expulsion per rectum of a colorectal polyp is exceedingly rare.

Published in the journal Gastroenterology Research, the authors report a rare and unusual case that they believe is the first of spontaneous expulsion of an adenomatous polyp during defecation. These patients should undergo colonoscopy to search for additional polyps as well as other gastrointestinal pathology.

A 60-year-old man, with past medical history of hypertension, diabetes mellitus, schizophrenia, and chronic constipation, visited his gastroenterologist with complaints of worsening lower abdominal pain and constipation for several weeks, not relieved with stool softeners and laxatives. He also reported, that during a bowel movement that morning, he had defecated “a piece of flesh” and bright red blood.

The pain had been increasing in intensity, especially over the last 3 days. He was taking stool softeners, an over-the-counter colon cleanser, and magnesium citrate for his chronic constipation. Attributing the worsening abdominal pain to constipation, he consumed a higher dose of magnesium citrate. After a few hours, he had a large bowel movement with “a piece of flesh” and bright red blood per rectum.

Subsequently, his abdominal pain improved, but he became concerned, collected the specimen in a container, and decided to visit his gastroenterologist. He had never experienced blood in the stool or black stools before. He denied any recent symptoms of fevers, chills, nausea, vomiting, diarrhea, change in appetite, or weight loss. He reported no family history of gastrointestinal malignancy. Previously, he had refused to undergo screening colonoscopy and to be screened with any of the other CRC screening modalities.

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