The clinical spectrum of duodenal polyps in pediatrics

T M Attard1, S C Abraham, C Cuffari

  • 1Department of Pediatrics, Division of Gastroenterology and Nutrition, The Johns Hopkins Hospital, Baltimore, MD 21287-2631, USA.

Insights

Pediatric duodenal polyps are uncommon (0.4%), often found in children with polyposis syndromes. In other children, Brunner's gland hyperplastic polyps are most common, presenting with abdominal pain.

Area of Science:

  • Pediatric Gastroenterology
  • Gastrointestinal Pathology
  • Endoscopic Procedures

Background:

  • Duodenal polyps are rare in pediatric populations.
  • Understanding their prevalence and characteristics is crucial for diagnosis and management.
  • Previous studies have not fully characterized these lesions in children.

Purpose of the Study:

  • To determine the prevalence of duodenal polyps in pediatric patients.
  • To describe the clinical presentation and histologic subtypes of these polyps.
  • To compare findings in syndromic versus nonsyndromic pediatric patients.

Main Methods:

  • Retrospective analysis of 18 years of data (1983-2001) from The Johns Hopkins Children's Center.
  • Inclusion of all pediatric patients (<21 years) with diagnosed duodenal polyps.
  • Histologic evaluation of polyps obtained via cold-forceps biopsy or snare cautery.

Main Results:

  • Duodenal polyps were identified in 0.4% of 5766 esophagogastroduodenoscopies (EGDs).
  • Adenomatous polyps were the most common histologic subtype (42%), followed by Brunner's gland hyperplastic polyps (33%).
  • Patients with polyposis syndromes were often asymptomatic, while nonsyndromic patients presented with abdominal pain and vomiting.

Conclusions:

  • Duodenal polyps are most frequently found in children with polyposis syndromes, who are often asymptomatic.
  • In nonsyndromic pediatric patients, Brunner's gland hyperplastic polyps are the most common type, with abdominal pain and vomiting as frequent symptoms.
  • Histologic subclassification is essential for understanding the clinical significance of pediatric duodenal polyps.
Abstract

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