Endoscopic Mucosal Resection of a Large Rectal Juvenile Polyp in a 7-Year-Old Child: A Case Report

Area of Science:

• Pediatric Gastroenterology
• Colorectal Surgery
• Diagnostic Imaging

Background:

• Pediatric hematochezia is a common yet diagnostically complex symptom.
• Delayed diagnosis can result from misdiagnosis, such as mistaking polyps for hemorrhoids.
• A 7-year-old female experienced a year of intermittent, painless hematochezia, leading to ineffective conservative treatment.

Purpose of the Study:

• To present a case of pediatric hematochezia caused by a large rectal polyp.
• To emphasize the importance of early endoscopic evaluation in pediatric lower gastrointestinal bleeding.
• To highlight Endoscopic Mucosal Resection (EMR) as a therapeutic option for pediatric colorectal polyps.

Main Methods:

• Initial diagnostic workup included an abdominal contrast-enhanced 3D CT scan to exclude acute surgical abdomen.
• Diagnostic colonoscopy identified a large, 20 mm × 25 mm sub-pedunculated polyp on the left rectal wall.
• The polyp was successfully removed using Endoscopic Mucosal Resection (EMR) with submucosal saline injection, snare resection, and titanium clip closure.

Main Results:

• Histopathological analysis confirmed the polyp as a retention polyp with cystic glandular dilation and inflammatory stroma.
• The patient underwent successful Endoscopic Mucosal Resection (EMR) without immediate or delayed complications.
• The minimally invasive EMR procedure provided an effective treatment for the large pediatric colorectal polyp.

Conclusions:

• Early endoscopic evaluation is critical for diagnosing the cause of unexplained lower gastrointestinal bleeding in children.
• Endoscopic Mucosal Resection (EMR) is an effective and minimally invasive therapeutic option for managing large pediatric colorectal polyps.
• This approach offers an excellent long-term prognosis for pediatric patients with colorectal polyps.