It consists of pointed or blunt finger like processes of lamina propria covered by epithelium that shows branching. This type is often sessile than pedunculated. Majority of this lesion is more than 1 cm in size and in fact 60% of villous adenoma are over 2 cm in diameter.
About 60% of villous adenoma arises in the rectum, 20% in the rectosigmoid junction, 10% in the sigmoid colon and 10% in all segments of the colon. It is more common in the 7th decade and this is rarely seen below the age of 45 years.
Two thirds of patients will present with bright red rectal bleeding. Discharge of mucus and watery diarrhea are also common. Weight loss is there. About half the patients will present with obstruction, constipation and lower abdominal colic. Hypokalaemia, hyponatraemia, hypochloraemia is also there.
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