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Rectal bleeding and polyps
T T Latt1, R Nicholl, P Domizio
1Academic Department of Paediatric Gastroenterology, St Bartholomew's Hospital, West Smithfield, London.
Insights
Colorectal polyps, though uncommon, cause rectal bleeding in children. Endoscopic colonoscopy allows for accurate diagnosis and removal of these polyps, especially in young children.
Area of Science:
- Pediatric Gastroenterology
- Endoscopic Surgery
- Colorectal Health
Background:
- Colorectal polyps are an uncommon cause of rectal bleeding in pediatric patients.
- Endoscopic procedures like colonoscopy are crucial for diagnosis and treatment.
Purpose of the Study:
- To audit the diagnosis and endoscopic treatment of colorectal polyps in children over a 10-year period.
- To evaluate the types, prevalence, and management of pediatric colorectal polyps.
Main Methods:
- A 10-year retrospective audit of a children's endoscopy unit.
- Analysis of 730 colonoscopies to identify and categorize colorectal polyps.
- Review of patient demographics, presenting symptoms, polyp characteristics, and treatment outcomes.
Main Results:
- Twenty-nine polyps were diagnosed in 730 colonoscopies.
- The majority were juvenile polyps (24), with others including inflammatory, Peutz-Jeghers, and adenomatous types.
- Rectal bleeding was a primary symptom in all children, with most patients under 5 years old.
Conclusions:
- Colonoscopy is effective for diagnosing and treating colorectal polyps in children.
- Total colonoscopy is recommended for persistent rectal bleeding to ensure comprehensive evaluation and management.
Abstract:
Colorectal polyps are an important albeit uncommon cause of rectal bleeding in children. Colonoscopy promotes both rapid and accurate diagnosis and the opportunity for immediate therapeutic polypectomy. A 10 year audit of polyps diagnosed and treated endoscopically has been undertaken in the children's endoscopy unit. Twenty nine polyps were diagnosed from 730 colonoscopies; 24 were juvenile, two inflammatory, two Peutz-Jeghers, and one an adenomatous polyp. All but one of the juvenile polyps were solitary. All children had bleeding per rectum as one of the major presenting features. About two thirds of the patients were under the age of 5 years; the mean age was 5.6 years. Most of the juvenile polyps were on the left side of the colon; 41% were distal to the sigmoid colon. However polyps were found throughout the colon, indicating that total colonoscopy is wise and rewarding in any child with persistent and intermittent rectal bleeding.