Colorectal Polyps in Childhood

Abstract

Introduction

Colorectal polyps are common in childhood and its incidence is 1% of all childhood population. More than 90% of children with colorectal polyp had juvenile polyp and that is commonly

found in the rectosigmoid colon. This study aimed to evaluate the patients treated in our clinic for colorectal polyp.

Material and Methods

Patients with colorectal polyp and treated in our clinic between the years 2005-2015 were included in this study. The demographic characteristics of the patients, their complaints, treatment and pathology results were evaluated.

Results

Eighty patients were included in this study; 52 of them were males and 28 were females. The mean age of these children was 5.5 ± 3.3 years. The presenting complaint was rectal bleeding in 50 and prolapse of rectal polyp in 30. Polyps were detected and excised by endoscopy in 77 of the patients and no polys were detected in other 3 patients. %80 of polyps were located on posterior rectal wall and 90% of all were pedunculated polyps. Solitary polyps were seen in 92% of the patients. Histopathologic results showed that most of them types were juvenile polyps (57%) and inflammatory polyps (30%). In all cases with multiple polyps the histopathologic types were juvenile

or inflammatory ones and mean age was older in this patient group.

Conclusion

A detailed family history should be taken from patients with colorectal polyps. Although polyps in childhood population are usually solitary and benign, it should be kept in mind that there may be multiple and precancerous ones.

 

Keywords

• Polyp,juvenile polyp,hamartomas,neoplasia,colorectal,child

Çocukluk Çağında Kolorektal Polipler

Öz

Giriş

Kolorektal polipler çocukluk çağında sık görülür ve okul öncesi- okul çağındaki çocukların %1’ini etkiler. %90’dan fazlası jüvenil poliptir ve çoğu rektosigmoid bölgededir. Bu çalışmada kolorektal polip nedeniyle kliniğimizde tedavi edilen  hastaların değerlendirilmesi amaçlandı.

Materyal ve metod

2005-2015 yılları arasında kolorektal polip nedeniyle kliniğimizde tedavi edilen hastalar çalışmaya dahil edildi. Hastaların demografik özellikleri, başvuru şikayetleri, uygulanan tedavi ve patoloji sonuçları değerlendirildi.

Sonuçlar

Toplam 80 hasta çalışmaya dahil edildi. Hastaların yaşları ortalama 5,5 ± 3,3 yaş olup, 52’si erkek, 28’i kızdı. Hastaların 50’si rektal kanama, 30’u anüsden dışarıya çıkan kitle şikayetiyle başvurmuştu. Endoskopide hastaların 77’sinde polip saptanıp eksize edildi, 3 hastada ise polip yoktu. Poliplerin

%80’i rektum arka duvarındaydı ve %90’ı saplıydı. Hastaların %92’sinde tek polip mevcuttu, en sık jüvenil polip (%57) ve inflamatuvar polip (%30) bulundu. Birden fazla sayıda polip saptanan olguların tamamında jüvenil ve inflamatuvar polip saptandı ve bu olguların yaş ortalaması daha yüksek bulundu.

Tartışma

Kolorektal polibi olan hastalarda detaylı bir aile öyküsü alınmalıdır. Çocukluk çağındaki polipler genellikle iyi huylu olmakla birlikte, multipl polipler ve pre kanseröz poliplerin olabileceği de akılda tutulmalıdır.

 

Anahtar Kelimeler

• Polip,jüvenil polip,hamartom,neoplazi,kolorektal,çocuk

Kaynakça

1. 1. Thakkar K, Alsarraj A, Fong E, Holub JL, Gilger MA, El Serag HB. Prevalence of colorectal polyps in pediatric colonoscopy. Dig Dis Sci. 2012; 57: 1050-1055. 2. Lee BG, Shin SH, Lee YA, Wi JH, Lee YJ, Pak JH. Juvenile polyp and colonoscopic polypectomy in childhood. Pediatr Gastroenterol Hepatol Nutr 2012; 15: 250-255. 3. Thakkar K, Fishman DS, Gilger MA. Colorectal polyps in childhood. Curr Opin Pediatr. 2012; 24: 632-637. 4. Ulukaya-Durakbaşa Ç, Çağlar M, Fettahoğlu S, et al. A clinical experience on pediatric colorectal polyps. Göztepe Tıp Dergisi 2012; 27: 1-5. 5. Mestre JR. The change pattern of juvenile polyps. Am J Gastroenterol 1986; 81: 312-314.
2. 6. Pillai RB, Tolia V. Colonic polyps in children: frequently multiple and recurrent. Clin Pediatr (Phila) 1998; 37: 253-257. 7. Euler AR, Seibert JJ. The role of sigmoidoscopy, radiographs, and colonoscopy in the diagnosis evaluation of pediatric age patient with suspected juvenile polyps. J Pediatr Surg 1981; 16: 500-502. 8. Ling UP, Chen JY, Hwang CJ, et al. Hydrosonography in the evaluation of colorectal polyps. Arch Dis Child 1995; 73: 70-73. 9. Poddar U, Thapa BR, Vaiphei K, Singh K. Colonic polyps: experience of 236 Indian children. Am J Gastroenterol 1998; 93: 619-622. 10. Gupta SK, Fitzgerald JF, Croffie JM, et al. Experience with juvenile polyps in North American children: the need for pancolonoscopy. Am J Gastroenterol. 2001; 96: 1695–1697.