Unusual Endoscopic Findings in Children

Abstract

Isolated polyps of the upper digestive tract are rarely diagnosed in children, being usually an incidental finding during endoscopic exploration.The diagnostic, therapy, and outcome of these lesions are based on endoscopy and pathology.In a 5-year period, clinical features, topography, size, pathology, therapeutics, and progression of esophagogastric polyps founded in children addressed to our pediatric gastroenterology unit were studied.The authors encountered 3 lesions in teenagers aged 13 to 17 years two males (2M), from a total number of 2140 upper digestive endoscopies (0.14%). All patients presented with pirosis, epigastric pain, and vomits; one of the children had end-stage renal disease and Kabuki syndrome. Endoscopic and pathologic findings were 2 esophageal polyps, an inflammatory one, and another containing goblet cells and a double-headed hyperplastic gastric polyp. Two patients received proton pump inhibitors without any improvement in subsequent endoscopic evaluations.The difficulties related to age group, underlying conditions, debatable response to acid suppression, and limited experience in pediatric therapeutic endoscopy selected significantly the effectiveness of treatment.The rarity of these lesions requires an individualized management, the endoscopic diagnostic, and therapeutic gesture depending on the symptoms, type, location, comorbidities, and team experience.

Kabuki Syndrome—Clinical Review with Molecular Aspects

“…Treatment should be individualized and may include proton pump inhibitors and, in case of lack of improvement, endoscopic polypectomy to relieve symptoms [91].…”

Multiple Esophageal Hyperplastic Polyps in a Nigerian Woman

“…The optimal treatment strategy is still to be defined. While some anecdotal reports showed regression of polyps after a course of anti-secretory therapy such as proton pump inhibitors [5,18], others have not demonstrated regression [14,18,22]. The minimum duration of anti-secretory therapy for polyp regression has also not been established.…”

“…The lesion is commonly associated with erosive esophagitis/or hiatal hernia [4][5][6]8,12,13]. Other potential etiologies include eosinophilic esophagitis, Crohn's disease, medication-induced esophagitis, infection, anastomotic or polypectomy sites, photodynamic therapy, and type 1 neurofibromatosis [5,8,14,15].…”

Asymptomatic Gastric Giant Polyp in a Boy with Peutz-Jeghers Syndrome Presented with Multiple Café Au Lait Traits

“…The most common pathological types in children are hyperplastic polyps, and most are asymptomatic and do not require removal. Gastric polyps are being encountered in less than 1% of upper gastrointestinal endoscopies performed in children [ 5 , 6 ].…”