Does painless rectal bleeding equate to a colonic polyp?

Campbell, Alison Morag; Sugarman, Ian

doi:10.1136/archdischild-2016-311245

Cited by 8 publications

(5 citation statements)

References 4 publications

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“…Multiple studies have reported that juvenile polyps were more common in male patients [3,4,7,13]. Our study, however, did not demonstrate a statistically significant difference between male and female patients.…”

Section: Discussioncontrasting

confidence: 89%

“…Three of them had proctitis. This rate is lower than that reported in a recent study that analyzed patients with painless rectal bleeding with or without abdominal pain but with no change in bowel movements, in which inflammatory bowel disease was present in 10.7% of the patients [13].…”

Section: Discussionmentioning

confidence: 58%

“…These studies differ from ours in that they reviewed all colonoscopies that demonstrated polyps without regard to the clinical presentation and included patients with polyposis syndromes. A recent study reported that only 19.5% of patients with painless lower gastrointestinal bleeding had polyps, and that when patients with an additional complaint of abdominal pain with no change in bowel movements were included in the analysis, only 14.8% were found to have polyps [13]. In contrast, our study included patients undergoing colonoscopy for isolated lower gastrointestinal bleeding, and we believe that excluding patients with polyposis syndromes and those with lower gastrointestinal bleeding associated with other complaints is likely a major reason for the different results obtained in our study.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic Findings in Children with Isolated Lower Gastrointestinal Bleeding

et al. 2019

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Background/Aims Colorectal polyps are a common cause of lower gastrointestinal bleeding in children. Our aim was to study the causes of isolated lower gastrointestinal bleeding and to analyze the characteristics of the colorectal polyps found in our cohort. Methods We retrospectively reviewed colonoscopic procedures performed between 2007 and 2015. Children with isolated lower gastrointestinal bleeding were included in the study. Results A total of 185 colonoscopies were performed for isolated lower gastrointestinal bleeding. The median patient age was 8 years, and 77 patients (41.6%) were found to have colonic polyps. Normal colonoscopy findings were observed and acute colitis was detected in 77 (41.6%) and 14 (7.4%) patients, respectively. Single colonic polyps and 2–3 polyps were detected in 73 (94.8%) and 4 (5.2%) patients with polyps, respectively. Of the single polyps, 69 (94.5%) were juvenile polyps, among which 65 (94.2%) were located in the left colon. Conclusions Single left-sided juvenile polyps were the most common cause of isolated lower gastrointestinal bleeding in our study. It was rare to find multiple polyps and polyps proximal to the splenic flexure in our cohort. A full colonoscopy is still recommended in all patients in order to properly diagnose the small but significant group of patients with pathologies found proximal to the splenic flexure.

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Section: Discussioncontrasting

confidence: 89%

Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

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Endoscopic Findings in Children with Isolated Lower Gastrointestinal Bleeding

et al. 2019

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“…In our study, the most common cause of isolated hematochezia was colorectal polyps (27.6%), which are in line with previous studies of 19.5–44.1%. 1 11 13 However, unlike previous studies we were also capable of identifying a relatively high proportion of patients with anal fissures (14.2%). Although, anal fissures can be observed by inspection and a history of constipation, there are uncertain cases in which the fissures are located in the anal canal or cases of an insufficient physical exam owing to the unwillingness of the child to cooperate.…”

Section: Discussionmentioning

confidence: 59%

Potential Utility of Fecal Calprotectin in Discriminating Colorectal Polyps From Other Major Etiologies in Children Presenting With Isolated Hematochezia

Kim

Choi

et al. 2022

J Korean Med Sci

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Background Colorectal polyps are the most common cause of isolated hematochezia in children, which requires a colonoscopy for diagnosis. We aimed to investigate the potential utility of fecal calprotectin (FC) in assessing colorectal polyps detected by colonoscopy among children presenting with isolated hematochezia. Methods Pediatric patients of the age of < 18 years who had undergone both colonoscopy and FC tests for isolated hematochezia from June 2016 to May 2020 were included in the present multicenter, retrospective, cross-sectional study. Comparative analysis was conducted between major causes of isolated hematochezia and FC cut-offs for discriminating colorectal polyps were explored. Results A total 127 patients were included. Thirty-five patients (27.6%) had colorectal polyps, followed by anal fissure (14.2%), ulcerative colitis (UC; 12.6%), and others. A significant difference in FC levels was observed between patients with colorectal polyps (median, 278.7 mg/kg), anal fissures (median, 42.2 mg/kg), and UC (median, 981 mg/kg) ( P < 0.001). According to receiver operating characteristic curve analysis, among patients diagnosed with colorectal polyp or anal fissure, the most accurate FC cut-off for discriminating colorectal polyps from anal fissures on colonoscopy was 225 mg/kg (sensitivity, 59.4%; specificity, 94.4%; positive predictive value [PPV], 95.0%; negative predictive value [NPV], 56.7%; area under the curve [AUC], 0.8; 95% confidence interval [CI], 0.678–0.923; P < 0.001), while among patients diagnosed with colorectal polyp or UC, the most accurate FC cut-off for discriminating colorectal polyps from UC on colonoscopy was 879 mg/kg (sensitivity, 81.2%; specificity, 56.2%; PPV, 78.8%; NPV, 60.0%; AUC, 0.687; 95% CI, 0.521–0.852; P < 0.001). Conclusion FC may assist in assessing the cause of lower gastrointestinal tract bleeding in children who present with isolated hematochezia.

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“…Colonic polyps are quite common in children, which are always isolated and benign. Painless lower gastrointestinal bleeding represents the most common presentation of colonic polyps in children [ 1 , 2 ]. Intussusception mainly occurs during infancy and early childhood.…”

Section: Introductionmentioning

confidence: 99%

Secondary Colo-Colic Intussusception Caused by Giant Polyp of Sigmoid Colon in a 5-Year-Old Girl

Haizhi,

Xiaobing,

Jianrong

2023

Case Rep Gastroenterol

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Intussusception is common in infants and young children. The most common type is small intestinal intussusception or ileo-colic intussusception. Colonic intussusception is rare. Intestinal polyps, especially large polyps or multiple polyps, can cause intussusception. Here, we report a rare case of colo-colic intussusception caused by a giant juvenile polyp of sigmoid colon, and the patient achieved good clinical effect through polypectomy under colonoscopy. So, when children have colonic intussusception, the possibility of colonic polyps should be considered.

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Does painless rectal bleeding equate to a colonic polyp?

Cited by 8 publications

References 4 publications

Endoscopic Findings in Children with Isolated Lower Gastrointestinal Bleeding

Endoscopic Findings in Children with Isolated Lower Gastrointestinal Bleeding

Potential Utility of Fecal Calprotectin in Discriminating Colorectal Polyps From Other Major Etiologies in Children Presenting With Isolated Hematochezia

Secondary Colo-Colic Intussusception Caused by Giant Polyp of Sigmoid Colon in a 5-Year-Old Girl

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