A clinical experience on pediatric colorectal polyps

Abstract

SUMMARY Background: Colorectal polyps are among the common causes for rectal bleeding in children. They rarely have malignant potential. This study aims to present a clinical experience on colorectal polyps with an emphasis on utility of colonoscopy in these children. Methods: File records of patients treated between the years 2001-2011 were retrospectively evaluated in terms of age, sex, diagnostic methods, localization of polyps and pathological results. Results: There were 63 patients with a mean age of 6 years (1-15 years). Among these, 38 (60 %) were males and 25 (40 %) females. The presenting complaint was rectal bleeding in 60, prolapsed polyps in 2 and prolapsed rectum in one. The use of colonoscopy was initiated within the last 9-month of the study period. The polyps were removed by transanal route in 54. Colonoscopy was done with successful removal in all except one for the remaining 9 and yielded polyps in rectum in 4, in sigmoid colon in 3, in transverse colon in one and multiple polyps in one. Histopathology results were available in 62 and consistent with juvenile polyps in 51, hamartamatous in 2, hyperplastic in 2, pseudopolyps in 4, lymphoid in 2 and inflammatory fibroid in one. Conclusions: Although many rectal polyps are palpated and can be removed by anorectal route in children, the incidence of nonpalpable rectal polyps and colonic polyps should not be underestimated. The polyps are benign in most children. Colonoscopic examination increases the diagnostic accuracy and adds to the treatment keeping the possible presence of premalignant conditions in these children. Routine colonoscopic examination should be offered for all children with suspected or proven polyps.