A STUDY OF JUVENILE POLYPS IN CHILDREN� diagnostic criteria and difficulties

Dr Meenakshi Balasubramanian; Dr Chinmay Saraf; Dr. Sanjay N. Oak; Dr. Vikas Kavishwar; Dr Shilpa K Lad; Dr Rawi Agrawal

Volume : V, Issue : X, October - 2016

A STUDY OF JUVENILE POLYPS IN CHILDREN� diagnostic criteria and difficulties

Dr Meenakshi Balasubramanian, Dr Chinmay Saraf, Dr. Sanjay N. Oak, Dr. Vikas Kavishwar, Dr Shilpa K Lad, Dr Rawi Agrawal

Abstract :

Polyps in the gastro-intestinal tract are common in children and occur in up to 1% of pre-school and school-going children. Colo-rectal polyps remain one of the most frequent causes of painless rectal bleeding in children. They can cause significant morbidity due to anaemia, protein energy malnutrition, intestinal obstruction and intussusception, which may ultimately affect the overall growth of the child. Juvenile polyps account for more than 90% of all polyps, and are a common cause of painless rectal bleeding in children. Rectum is the commonest site for these polyps. These polyps are usually solitary, but may be multiple. If more than 5, the condition is called as juvenile polyposis coli. While solitary polyps have no malignant potential, juvenile polyposis does carry a risk for malignant transformation. A retrospective study of 63 cases of colorectal juvenile polyps in the age group of 0-15years was done over a 5 year period, at a tertiary care center. This study aimed to evaluate the age of presentation, sex preponderance and common presenting symptoms of juvenile polyps, to study gross morphological features and microscopic variations of juvenile polyps and to review indications for colectomy in juvenile polyps. There were 61 cases of juvenile rectal polyps in our study. 53/61 cases were single, 2 cases had polyps more than 1, but less than 5 and there were 6 cases with more than five colonic polyps, qualifying the terminology of juvenile polyposis coli. Rectum was the commonest site for solitary juvenile polyps accounting to 90.28% of cases. Dysplastic or adenomatous change was not seen in any of the cases of solitary juvenile polyps. 4/6 cases of juvenile polyposis coli showed cauliflower like projections on gross examination, and these showed adenomatous changes on histology. Identification of adenomatous change is important as this would predispose for colonic adenocarcinoma and therefore needs definitive correction.