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Life-threatening gastrointestinal hemorrhage due to juvenile polyposis
D Pashankar1, J J Murphy, A Ostry
1Department of Pediatrics, British Columbia's Children's Hospital, Vancouver, Canada.
Insights
Juvenile polyposis, a rare cause of lower gastrointestinal bleeding in children, can present with massive hemorrhage. This case highlights the importance of considering this condition in pediatric patients with severe GI bleeding.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Pathology
Background:
- Juvenile polyposis is a rare hamartomatous polyposis syndrome.
- It typically presents in childhood with gastrointestinal bleeding, intussusception, or obstruction.
Observation:
- A previously healthy 14-year-old boy presented with massive lower gastrointestinal hemorrhage.
- Endoscopic and radiological evaluations were followed by laparotomy and intraoperative colonoscopy.
- Multiple colonic polyps were identified, necessitating a hemicolectomy due to severe bleeding.
Findings:
- Histological examination and family history confirmed the diagnosis of juvenile polyposis.
- This presentation of massive hemorrhage is extremely rare, with only one prior reported case.
- Juvenile polyposis requires consideration in the differential diagnosis of life-threatening pediatric GI hemorrhage.
Implications:
- This case underscores the potential for severe, life-threatening presentations of juvenile polyposis in pediatric patients.
- Early consideration of juvenile polyposis in the differential diagnosis of severe pediatric GI bleeding is crucial.
- Understanding the clinical features and therapeutic options for juvenile polyposis is essential for effective management.
Abstract:
A 14-yr-old, previously healthy boy presented with massive lower GI hemorrhage. After the routine endoscopic and radiological evaluation, laparotomy and intraoperative colonoscopy revealed multiple polyps in the colon. A hemicolectomy was performed because of the severity of hemorrhage. A diagnosis of juvenile polyposis was made based upon histological findings and the family history. This is an extremely unusual presentation of juvenile polyposis and has been reported only once before. The clinical features, diagnosis, and therapeutic options for juvenile polyposis are discussed. Juvenile polyposis, although a rare condition in the pediatric population, should be considered in the differential diagnosis of life-threatening GI hemorrhage.
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