Giant colon polyp in a child with suspected inflammatory bowel disease: US findings

Area of Science:

• Pediatric Gastroenterology
• Diagnostic Imaging
• Gastrointestinal Pathology

Background:

• Inflammatory bowel disease (IBD) is a differential diagnosis in children presenting with chronic diarrhea and rectal bleeding.
• Ultrasound (US) is a non-invasive imaging modality increasingly utilized in the evaluation of pediatric gastrointestinal conditions.

Observation:

• A 6-year-old boy with a history of diarrhea and rectal bleeding underwent abdominal ultrasound for suspected IBD.
• US revealed an echoic, oval, mobile mass (30 x 24 mm) attached by a pedicle at the transverse-descending colon junction.
• Color Doppler demonstrated intralesional blood flow within the mass.

Findings:

• The ultrasound findings were highly suggestive of a colonic polyp.
• Subsequent colonoscopy confirmed the presence of a polyp.
• Histologic examination of the resected mass revealed a 32 mm hamartomatous polyp.

Implications:

• This case highlights the utility of ultrasound in the initial diagnosis of colonic polyps in children, differentiating them from IBD.
• Early detection and removal of hamartomatous polyps are crucial to prevent potential complications such as intussusception or bleeding.
• Further research into the role of advanced US techniques in characterizing pediatric colonic lesions is warranted.