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Published on: June 8, 2020
Colorectal polyps: a frequently-missed cause of rectal bleeding in Egyptian children
M H F El-Shabrawi1, Z E El Din, M Isa
1Departments of Pediatrics, Cairo University, Egypt. melshabrawi@medicine.cu.edu.eg
Insights
Colorectal polyps are a common cause of rectal bleeding in Egyptian children, often diagnosed via colonoscopy. Prompt treatment through colonoscopic polypectomy effectively stops bleeding, making polyps a key consideration in diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Colorectal Surgery
- Epidemiology
Background:
- Rectal bleeding is a common pediatric complaint, but colorectal polyps are infrequently reported in Egyptian children.
- Understanding the prevalence and characteristics of colorectal polyps is crucial for accurate diagnosis and management.
Purpose of the Study:
- To determine the prevalence and characteristics of colorectal polyps in Egyptian children presenting with fresh rectal bleeding.
- To evaluate colorectal polyps as a cause of rectal bleeding in this pediatric population.
Main Methods:
- A prospective cohort study of 174 Egyptian children (aged 2-12 years) with fresh rectal bleeding.
- Involved rectal examination, laboratory investigations, and fiber-optic colonoscopy for all participants.
Main Results:
- Colorectal polyps were diagnosed in 57.4% of patients (100 children).
- Juvenile polyps were most common (84%), predominantly located in the rectum.
- Colonoscopic polypectomy was successful in all cases, arresting rectal bleeding.
Conclusions:
- Colorectal polyps are a relatively common and treatable cause of fresh rectal bleeding in Egyptian children.
- Colorectal polyps should be a primary consideration in the differential diagnosis of rectal bleeding in this demographic.
Objectives:
Colorectal polyps are important causes of rectal bleeding but they have been infrequently reported in Egyptian children. The prevalence and characteristics of colorectal polyps in a consecutive cohort of Egyptian children with rectal bleeding are presented.
Methods:
A total of 174 children aged 2-12 years [mean (SD) 6.4 (3.7)] with fresh rectal bleeding were enrolled prospectively. Rectal examination, laboratory investigations and fibre-optic colonoscopy were performed in all patients.
Results:
The source of bleeding was diagnosed as colorectal polyps in 100 patients (57.4%) and was owing to other causes in 74. The interval between onset of symptoms and presentation ranged from 2 to 48 months [mean (SD) 18.3 (16)]. In patients with other causes, rectal bleeding was attributed to intestinal amoebiasis (42), diarrhoea/dysentery (18), severe constipation (2) and intestinal schistosomiasis (2). Polyps were solitary in 56 children (56%) and ranged from 2 to 5 in 34 (34%) and >5 in 10 (10%). Polyps were confined to the rectum in 68 children, were rectosigmoid in 20, in the descending colon in 8, and splenic flexure in 4. Polyps were juvenile in 84 children (84%), inflammatory in 10 (10%) and hyperplastic, schistosomal or adenomatous in 2 each (6%). Colonoscopic polypectomy was successful and arrested the bleeding in all cases.
Conclusion:
In Egyptian children, colorectal polyps are relatively common and an easily treatable cause of fresh rectal bleeding. They should be high on the list of differential diagnoses.
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