JUVENILE POLYP FROM SYMPTOM TO DIAGNOSIS AND THE ROLE OF ULTRASONOGRAPHY: A CASE REPORT

Abstract

Aims: Juvenile polyps are the most common intestinal polyps in children, but they are also found relatively frequently in adults. Although colonoscopy and pathologic examinations are essential for the final diagnosis of juvenile polyps, our aim is to show that ultrasound imaging can also reveal the juvenile polyps. Case Report: In a 21-year-old female patient with painless rectal bleeding and abdominal pain, blood tests showed no signs of anemia or infection, but the fecal occult blood test was found to be positive. Ultrasound imaging prior to colonoscopy revealed the juvenile polyp. The polyp was resected during colonoscopy via hot snare polypectomy and then it was pathologically diagnosed as a juvenile polyp. Conclusion: Ultrasonography is not a very common diagnostic tool for colonic polyps, but it may have the potential of revealing a colonic polyp such as a juvenile polyp. This can ease the process of diagnosis.

Keywords

• Juvenile polyp
• ultrasonography
• colonoscopy

References

1. 1. Jelsig AM, Ousager LB, Brusgaard K et al. Juvenile polyps in den- mark from 1995 to 2014. Dis Colon Rectum 2016;59(8):751-7.
2. 2. Chen W, Wang D, Jia L et al. Colorectal polyps in children: a retrospective study of clinical features and the value of ultrasonog- raphy in their diagnosis. J Pediatr Surg 2012;47(10):1853-8.
3. 3. Parra DA, Navarro OM. Sonographic diagnosis of intestinal pol- yps in children. Pediatr Radiol 2008;38(6):680-4.
4. 4. Lelli JL. Polypoid diseases of gastrointestinal tract. In: Jay LG, James AO, Arnold GC, editors. Pediatric Surgery. Philadelphia: Mosby; 2006.p.1414-26.
5. 5. Malandra M, Kaur S, Chogle A. Utility of routine colonic biopsies in pediatric colonoscopic polypectomy for benign juvenile hamar- tomatous polyps. J Pediatr Gastroenterol Nutr 2017;64(4):555-8.
6. 6. Thomson M, Tringali A, Dumonceau JM et al. Paediatric gas- trointestinal endoscopy: European Society for paediatric gastro- enterology hepatology and nutrition and European Society of gas- trointestinal endoscopy guidelines. J Pediatr Gastroenterol Nutr 2017;64(1):133-53.
7. 7. Vitale V, Di Serafino M, Mercogliano C et al. Giant colon polyp in a child with suspected inflammatory bowel disease: US findings. J Ultrasound 2014;19(1):53-5.
8. 8. Wang X, Jia C, Yang H et al. Sonographic features of a ju- venile polyp: a case report and literature review. Clin Imaging 2014;38(2):215-7.

9. 9. Hosokawa T, Hosokawa M, Tanami Y et al. Diagnostic per- formance of ultrasound without any colon preparation for de- tecting colorectal polyps in pediatric patients. Pediatr Radiol 2019;49(10):1306-12.
10. 10. Nugent KP, Talbot IC, Hodgson SV et al. Solitary juvenile pol- yps: not a marker for subsequent malignancy. Gastroenterology 1993;105(3):698-700.
11. 11. Lin HC, Fiorino KN, Blick C et al. A rare presentation and diag- nosis of juvenile polyposis syndrome and hereditary hemorrhagic telangiectasia overlap syndrome. Clin Imaging 2015;39(2):321-4. 12. Brosens LA, van Hattem A, Hylind LM et al. Risk of colorectal cancer in juvenile polyposis. Gut 2007;56(7):965-7.