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The management of colonic polyps in children: a 13-year retrospective study
Valeria Dipasquale1, Claudio Romano2, Mauro Iannelli1
1Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Via Consolare Valeria 1, 98124, Messina, Italy.
Insights
Lower gastrointestinal bleeding is the most common symptom of colonic polyps in children. Right-sided polyps can be larger than left-sided ones, making total colonoscopy essential for diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Colorectal Surgery
- Diagnostic Endoscopy
Background:
- Colonic polyps are common in children, typically benign and left-sided.
- Understanding pediatric colonic polyp characteristics is crucial for accurate diagnosis and management.
Purpose of the Study:
- To determine the frequency, symptoms, and characteristics of colonic polyps in a pediatric cohort.
- To analyze clinical presentation, polyp features, and outcomes in children with colonic polyps.
Main Methods:
- Retrospective chart review of pediatric patients (≤18 years) diagnosed with colonic polyps between 2006-2019.
- Data collection included demographics, clinical presentation, family history, polyp characteristics, and associated lesions.
- Statistical analysis to compare clinical presentation with age, polyp location, and size.
Main Results:
- 35 Caucasian children diagnosed with juvenile colonic polyps; 65.7% were male.
- Lower gastrointestinal bleeding (97%) was the predominant symptom, with a mean duration of 5.3 months.
- Right-sided polyps were significantly larger than left-sided polyps (p=0.037), though location and size did not significantly alter clinical presentation.
Conclusions:
- Lower gastrointestinal bleeding is the most frequent presenting symptom of colonic polyps in children.
- Right-sided colonic polyps occur and can be larger than left-sided polyps.
- Total colonoscopy is mandatory for all suspected cases of colonic polyps in children to ensure comprehensive evaluation.
Abstract:
The aim of this study was to describe the frequency, major symptoms, and characteristics of colonic polyps in a cohort of children. A retrospective chart review of patients aged ≤ 18 years who were diagnosed with colonic polyp(s) from 2006 to 2019 in a tertiary hospital was included. Data collected included demographics, clinical presentation, interval of time between the onset of symptoms and the endoscopic diagnosis of colonic polyps, family history, characteristics of the polyp, and associated lesions. Over the study period, 35 Caucasian children were diagnosed with juvenile colonic polyps. Twenty-three patients (65.7%) were males. Lower gastrointestinal bleeding of a mean duration of 5.3 ± 4.9 months was the presenting symptom in nearly all cases (n = 34, 97%), and it was isolated in 17 patients. Clinical presentation did not significantly vary according to the age or the location or size of the polyp (p = 0.262, p = 1.000, and p = 0.149, respectively). The polyps were mainly located in the left colon (n = 29, 83%). Right colonic polyps were significantly larger than left colonic polyps (p = 0.037).Conclusion: Lower gastrointestinal bleeding represents the most common presentation of colonic polyps in children. Right-sided colonic polyps occur and may be even larger than left-sided ones. A total colonoscopy is therefore mandatory for all cases of suspected colonic polyps. This study represents a real-life contribution, and it can help improve the management strategies of this condition in childhood. What is Known: • Colonic polyps are quite common in children. • The majority of pediatric colonic polyps are solitary, benign, and located in the left colon. What is New: • Right-sided colonic polyps occur and may be even larger than left-sided ones. • A total colonoscopy is mandatory for all cases of suspected colonic polyps.
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