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Minimal access surgical management of large juvenile polyps in children
1Division of Pediatric Surgery, Miller Children's Hospital, Long Beach, CA 90806, USA.
Insights
Giant juvenile polyps, rare in children, can cause significant symptoms. These large polyps may require surgical removal, as endoscopic methods may not be suitable for effective treatment.
Area of Science:
- Pediatric Gastroenterology
- Surgical Oncology
Background:
- Juvenile polyps affect up to 2% of children, typically presenting as small, distal lesions.
- Giant juvenile polyps are exceptionally rare, posing unique clinical challenges.
Observation:
- Two pediatric cases of giant juvenile polyps (>5 cm) were observed, one in the hepatic flexure and two in the cecum.
- Symptoms included recurrent rectal bleeding, anemia, and abdominal pain, necessitating intervention.
Findings:
- Standard colonoscopic removal was not feasible due to polyp size and location.
- Minimally invasive surgical techniques, including laparoscopic colectomy and colotomy with polypectomy, were successfully employed.
- Both patients experienced short hospital stays and favorable outcomes.
Implications:
- Giant juvenile polyps in children necessitate consideration of surgical resection.
- Minimally invasive surgical approaches offer effective treatment options for these rare pediatric conditions.
Background:
Juvenile polyps have a reported incidence of up to 2% in individuals younger than of 18 years. Most polyps are small, occur in the distal colon and rectum, and present with bleeding or prolapse. Giant juvenile polyps have been rarely reported.
Case Reports:
We encountered 2 unique presentations of very large juvenile polyps in children. A 9-year-old boy presented with recurrent rectal bleeding and anemia because of a single large polyp at the hepatic flexure. A 14-year-old boy presented with abdominal pain secondary to 2 large polyps in the cecum. The polyps were seen on colonoscopy as pedunculated masses larger than 5 cm and were not subjected to biopsy. Both patients underwent laparoscopic colon mobilizations with extracorporeal segmental resection in the first patient and colotomy and polypectomy in the second. Both patients had short hospital stays and excellent outcomes.
Conclusions:
Giant juvenile polyps are rare in children and may not be amenable to colonoscopic removal. They can be resected effectively with minimal access surgical techniques.
