Related Experiment Videos
Ultrasonographic diagnosis of juvenile colonic polyps
Insights
Saline enema ultrasonography safely diagnoses juvenile colonic polyps in children with rectal bleeding. This method accurately identifies polyps, offering a safer alternative to traditional procedures.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
- Colorectal Surgery
Background:
- Rectal bleeding in children often necessitates diagnostic procedures.
- Air-contrast barium enemas and colonoscopy carry inherent risks.
- Safer imaging alternatives are needed for pediatric patients.
Purpose of the Study:
- To evaluate the efficacy and safety of saline enema ultrasonography.
- To assess its utility in diagnosing juvenile colonic polyps in children.
- To establish a less invasive diagnostic tool for pediatric rectal bleeding.
Main Methods:
- Thirty-nine children (age 2y 8mo–8y 3mo) with rectal bleeding underwent ultrasonographic examination with saline enemas.
- Hydrocolonic ultrasonography findings were compared with immersion ultrasonography of removed specimens.
- Histological confirmation was obtained for ultrasonographically identified polyps.
Main Results:
- Ultrasonography detected juvenile colonic polyps in 25 children, confirmed histologically.
- Polyps were solitary, pedunculated, and located in various colonic segments.
- No adverse reactions were reported during or after the saline enema examinations.
- 14 children with normal ultrasonographic findings had no further bleeding.
Conclusions:
- Saline enema ultrasonography is a safe and accurate method for evaluating children with rectal bleeding.
- It is particularly effective for diagnosing juvenile colonic polyps.
- This technique offers a valuable, low-risk alternative to conventional endoscopic procedures.
Abstract:
To reduce the risks of air-contrast barium enemas and colonoscopy, we studied the use of saline enemas for ultrasonographic examination of children with rectal bleeding. Thirty-nine children, from 2 years 8 months to 8 years 3 months of age, were examined. Juvenile colonic polyps were ultrasonographically demonstrated and histologically confirmed in 25 children; all the polyps were solitary and pedunculated, and were located in the splenic flexure in 3 children, the descending colon in 6, the sigmoid colon in 12, and the rectum in 4. Ultrasonographic findings by hydrocolonic ultrasonography were identical to those obtained by immersion ultrasonography of removed specimens. Hypoechoic areas within more hyperechoic polyps were shown histologically to be dilated glandular canals. The 14 children in whom no abnormal ultrasonographic findings were shown had no further rectal bleeding after resuming regular defecation, and 5 of these 14 had negative colonoscopic findings. No adverse reactions were noted in any child during or after the saline enema examination. We conclude that ultrasonographic examination with a saline enema is a safe and accurate method of assessing children with rectal bleeding, especially for the diagnosis of juvenile colonic polyps.