Colorectal polyps: a frequently-missed cause of rectal bleeding in Egyptian children

Abstract

Objectives: Colorectal polyps are important causes of rectal bleeding but they have been infrequently reported in Egyptian children. The prevalence and characteristics of colorectal polyps in a consecutive cohort of Egyptian children with rectal bleeding are presented. Methods: A total of 174 children aged 2-12 years [mean (SD) 6.4 (3.7)] with fresh rectal bleeding were enrolled prospectively. Rectal examination, laboratory investigations and fibre-optic colonoscopy were performed in all patients.Results: The source of bleeding was diagnosed as colorectal polyps in 100 patients (57.4%) and was owing to other causes in 74. The interval between onset of symptoms and presentation ranged from 2 to 48 months [mean (SD) 18.3 (16)]. In patients with other causes, rectal bleeding was attributed to intestinal amoebiasis (42), diarrhoea/ dysentery (18), severe constipation (2) and intestinal schistosomiasis (2). Polyps were solitary in 56 children (56%) and ranged from 2 to 5 in 34 (34%) and .5 in 10 (10%). Polyps were confined to the rectum in 68 children, were rectosigmoid in 20, in the descending colon in 8, and splenic flexure in 4. Polyps were juvenile in 84 children (84%), inflammatory in 10 (10%) and hyperplastic, schistosomal or adenomatous in 2 each (6%). Colonoscopic polypectomy was successful and arrested the bleeding in all cases. Conclusion: In Egyptian children, colorectal polyps are relatively common and an easily treatable cause of fresh rectal bleeding. They should be high on the list of differential diagnoses.

Immunohistochemical Expression of Stem Cell Markers Cd44, Cd166 and Aldh1a1 in Non-Neoplastic Polyps of the Colon in Sample of Iraqi Patients

“…Recently there is a steady decline in incidence during childhood which may be due to auto-amputation and or regression of polyps which may be caused by existence for along time with possibility of ischemic changes. Similar polyps were recorded in adults also and this correspond with other studies and frequency of juvenile polyps are similar to the results of El-Shabrawi et al 2011 31 . Differences regarding gender distribution in the current study did not reach statistical significance except it is slightly lower in males than females with hamartomatous polyps, and this is not in agreement with previous studies in which male predominance was noticed 9,24,26,28,29 .…”

Fecal Occult Blood and Fecal Calprotectin as Point-of-Care Markers of Intestinal Morbidity in Ugandan Children with Schistosoma mansoni Infection

“…It can manifest with a wide range of symptoms depending on the extent of the inflammation and friability of the mucosa, ranging from intermittent abdominal pain to overt acute dysentery. By performing colonoscopy studies, colorectal schistosomiasis has been consistently associated with findings of intestinal polyps and pseudopolyps that can present as blood-per-rectum in affected individuals [6] .…”

Use of Fecal Occult Blood Tests as Epidemiologic Indicators of Morbidity Associated with Intestinal Schistosomiasis during Preventive Chemotherapy in Young Children

“…For example, intestinal morbidity includes diarrhea, abdominal pain, intestinal granulomas and fibrosis, polyps and microulcerations, and colonic obstruction in extreme cases 4–10. Perforation of the intestinal mucosa by S. mansoni eggs and colorectal polyps can cause the release of blood into the bowel, resulting in blood in feces and anemia if infections are heavy 4,5…”