Diagnostic value of intraoperative fiberscopy for small-intestinal polyps in familial adenomatosis coli.

X-ray examination and intraoperative fiberscopy of the small intestine were performed in 20 patients with familial adenomatosis coli. Roentgenographic study detected polypoid lesions in the upper jejunum in 2 patients (10%), and in the terminal ileum in 9 (45%). In contrast, endoscopic study revealed polyps in the jejunum in 10 patients (50%), and in the ileum in 14 (70%). Polyps in most cases were multiple and small in size (less than 3 mm in diameter). Histology revealed the lesions of the jejunum to be adenomas, and those of the ileum to be lymphoid hyperplasia with or without adenoma. The present study suggests that intraoperative endoscopy is much more valuable than roentgenography in detecting these minute polyps of the small intestine in this disease.