Juvenile Polyp in Thai Children—Clinical and Colonoscopic Presentation

Ukarapol, Nuthapong; Singhavejakul, Jesda; Lertprasertsuk, Nirush; Wongsawasdi, Lumduan

doi:10.1007/s00268-005-0686-5

Cited by 16 publications

(8 citation statements)

References 25 publications

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“…However, a significant number of patients had polyps proximal to the sigmoid colon, which indicates the imperative need for performing a total colonoscopy in symptomatic children, which is in agreement with other studies [16,[19][20][21] .…”

Section: Discussionsupporting

confidence: 81%

Colorectal Polyps: A Clinical, Endoscopic and Pathologic Study in Iranian Children

Ashtiani¹,

Monajemzadeh²,

Motamed

et al. 2008

Med Princ Pract

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Objective: To study the clinical presentation, histology and colonoscopic features of lower gastrointestinal polyps in Iranian children. Material and Methods: Medical reports of children with colorectal polyps were retrospectively reviewed from 1996 to 2005 at the Children’s Medical Center Hospital, Iran. A total of 563 cases were studied. Data related to age, sex, family history, signs and symptoms, the size, location, polyp types and associated lesions were collected and analyzed. Results: The mean age of children was 5.66 ± 2.88 years (range 2 months to 17 years), with a male-to-female ratio of 1.61:1.0. The highest incidence was between ages 2 and 10 years (85.1%). Rectal bleeding was the presenting symptom in 78.5% cases. The polyps were solitary in 94% of cases. A majority of polyps (86.3%) were juvenile and 86.7% located in the rectosigmoid area. Three percent of cases had a positive family history. One case of Turcot syndrome was also identified. Conclusion: Juvenile polyps remain the most common polyps in Iranian children. Although the presence of a solitary polyp in the rectosigmoid colon is more prevalent, in a significant number of cases they are multiple and located in proximal parts. Polyps must be removed even when asymptomatic because of their probable neoplastic potential.

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Section: Discussionsupporting

confidence: 81%

Colorectal Polyps: A Clinical, Endoscopic and Pathologic Study in Iranian Children

Ashtiani¹,

Monajemzadeh²,

Motamed

et al. 2008

Med Princ Pract

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“…Those who had colectomy and were followed up over several years settled to an average of seven bowel movements daily [15] . A report from Thailand of 32 patients emphasized that most polyps were in the rectosigmoid, but 20% of patients had right-sided polyps, as in our patient [16] . Surgical management was not discussed in this report.…”

Section: Discussionsupporting

confidence: 43%

Colonic polyposis in a 15 year-old boy: Challenges and lessons from a rural resource-poor area

Kakembo

Kisa

Fitzgerald

et al. 2016

Annals of Medicine &Amp; Surgery

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IntroductionColorectal polyps usually present with rectal bleeding and are associated with increased risk of colorectal carcinoma. Evaluation and management in resource-poor areas present unique challenges.Presentation of caseThis 15 year-old boy presented with 9 years of painless rectal bleeding and 2 years of a prolapsing rectal mass after passing stool. He had 3 nephews with similar symptoms. On clinical assessment and initial exam under anesthesia, an impression of a polyposis syndrome was made and a biopsy taken from the mass that revealed inflammatory polyps with no dysplasia. He was identified during a pediatric surgical outreach to a rural area with no endoscopy, limited surgical services, and no genetic testing available, even at a tertiary center. He subsequently had a three-stage proctocolectomy and ileal pouch anal anastomosis with good outcome after referral to a tertiary care center. The surgical specimen showed many polyps scattered through the colon.DiscussionIn the absence of endoscopic surveillance and diagnostic services including advanced pathology and genetic testing, colorectal polyposis syndromes are a significant challenge if encountered in these settings. Reports from similar settings have not included this surgical treatment, often opting for partial colectomy. Nonetheless, good outcomes can be achieved even given these constraints. The case also illustrates the complexity of untreated chronic pediatric surgical disease in rural resource-poor areas with limited health care access.ConclusionPolyposis syndromes in children present unique challenges in rural resource-poor settings. Good outcomes can be achieved with total proctocolectomy and ileal pouch anastomosis.

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“…Up to 90% of colorectal polyps that arise in children are of the juvenile subtype, and 80%-90% of these exist in either the sigmoid colon or rectum [2]. Given the risk of being associated with cancerous polyposis syndromes (Familial adenomatous polyposis, Gardner's, Turcot's, to name a few), colonoscopy and polypectomy have increasingly been used in managing children with recurrent bleeding, pain, or other symptoms associated with colorectal polyps [3,4].…”

Section: Introductionmentioning

confidence: 99%

Juvenile Retention Polyp in a Teenager

McClanahan

Palomo

Burleson

et al. 2021

Cureus

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The proper management of a prolapsed rectal mass in a child or teenager is challenging. Given that the underlying etiology of a prolapsed rectal mass in this population is not always immediately clear, interdisciplinary assessment is often required. Juvenile polyps, more commonly presenting with bleeding than a prolapsed mass, can mimic the appearance of both hemorrhoids and the rectum itself -making a purely clinical diagnosis difficult. Presented here is a case of a prolapsed colorectal polyp in a teenage boy, who underwent manual reduction of the mass, followed by colonoscopy and endoscopic ligation. Further histological evaluation revealed it to be a juvenile retention polyp. Despite the rarity of polyp prolapse as a presenting symptom, this case underscores the importance of considering colonic polyps as the etiology of a prolapsed anorectal mass in a teenager.

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Juvenile Polyp in Thai Children—Clinical and Colonoscopic Presentation

Abstract: Because of the high prevalence of right-sided polyps and the concern about malignant transformation, colonoscopy should be considered as the initial evaluation in children with rectal bleeding.

Cited by 16 publications

References 25 publications

Colorectal Polyps: A Clinical, Endoscopic and Pathologic Study in Iranian Children

Colorectal Polyps: A Clinical, Endoscopic and Pathologic Study in Iranian Children

Colonic polyposis in a 15 year-old boy: Challenges and lessons from a rural resource-poor area

Juvenile Retention Polyp in a Teenager

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