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[Recto-colic polyps in the child. Analysis of 183 cases]
J F Mougenot1, M E Baldassarre, L M Mashako
1Service de Gastroentérologie, Hôpital Robert Debré, Paris.
Insights
Pediatric colonoscopy revealed juvenile polyps in most children with rectal bleeding. Endoscopic resection is a safe and effective treatment for these common gastrointestinal polyps in young patients.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Endoscopy
- Pediatric Surgery
Context:
- Colonoscopy is an essential diagnostic tool in pediatric care.
- Gastrointestinal polyps in children can present with various symptoms, most commonly rectal bleeding.
- Understanding the types and management of pediatric polyps is crucial for effective treatment.
Purpose:
- To analyze the findings and outcomes of colonoscopies performed in children under 15 years old.
- To evaluate the efficacy and safety of endoscopic polyp resection in the pediatric population.
- To characterize the histological types of polyps found in this pediatric cohort.
Summary:
- A total of 1,533 colonoscopies were performed on children under 15, identifying 274 polyps in 183 patients.
- Juvenile polyps were the most common histological finding (125/129), with rectal bleeding as the primary symptom.
- Endoscopic resection was successful for 239 polyps, with rare complications of hemorrhage and perforation.
Impact:
- This study highlights the high prevalence of juvenile polyps in children undergoing colonoscopy.
- It confirms the safety and effectiveness of endoscopic polypectomy as a primary treatment modality in pediatric patients.
- Findings contribute to the clinical management guidelines for pediatric gastrointestinal polyp diagnosis and treatment.
Abstract:
Between January 1974 and April 1988, 1,533 colonoscopy were carried out in children less than 15 years old. Two hundred and seventy-four polyps were demonstrated in 183 children (106 boys, 77 girls, mean age: 6 years). The main symptom in most cases was rectal bleeding during defecation. A family history of polyps or digestive cancer was found in 6% of all patients. Two hundred and thirty-nine polyps were removed by endoscopic resection, 232 of them by the diathermic snare and 7 by William's hot biopsy technique. Histological examination of 129 polyps revealed a juvenile polyp in 125 cases, an hyperplastic polyp in 2 cases, a lymphoid polyp in 1 case and an adenoma in 1 case. No complications were observed except for one case each of hemorrhage and perforation following endoscopic polypectomy.