All issues > Volume 30(10); 1987

Original Article

J Korean Pediatr Soc. 1987;30(10):1134-1142. Published online October 31, 1987.

A Clinical Study on Gastrointestinal Polyps in Infancy and Childhood.

Soo Kyoung Chang¹, Ki Sup Chung¹

¹Department of Pediatrics, Yonsei University, College of Medicine, Seoul, Korea

Abstract

Gastrointestinal polyps in infants and children are relatively rare, but they occur frequently enough to merit attention and consideration as a cause of chronic intermittent rectal bleeding of small amounts. Total 69 cases of gastrointestinal polyps under 15 years of age who had been admitted to Department of Pediatrics, Yonsei University College of Medicine for 11 years from January, 1975 to June, 1985 were clinically studied and analized. The results were as follows: 1) Thirty-eight cases of gastrointestinal polyps in our series occurred between the ages of 3 and 5years (55.0%) and sex incidence showed that male is predominanted in a proportion of 2.1:1. 2) Most important single symptom was rectal bleeding of small amounts of fresh bright red blood (89.9%) without anemia. Protrusion of a mass from the anus (17.4%) and abdominal pain (14.5%) were noted as accompanying symptoms. The great majority of the patients had the duration of sympotoms from six months to three years, but patients with protrusion of a mass from the anus had relatively short duration. 3) Of 69 cases, 60 cases had single polyp (87.0%), and 9 cases had multiple polyps (13.0%). Of 60 cases with single polyp, 37 cases (53.6%) had their polyp in the rectum, 13 cases (18.8%) in the sigmoid colon, 6 cases (8.7%) in the descending colon, 2 cases (2.8%) in the anus, and 1 case (1.4%) in the transverse colon. Of 9 cases with multiple polyps, 5 cases (7.2%) had their polyps in the colon, 1 cases (1.4%) in the stomach and small intestine, and 3 cases (4.3%) were Peutz-Jeghers syndrome. The majority of patients (55.4%) had the diameter of polyp between 1.0-2.0 cm. 4) Of 59 cases who were analized pathologically, 36 cases had juvenile polyp, 11 cases inflammatory polyp, 10 cases adenomatous polyp, and 2 cases fibroepithelial polyp. 5) Of 60 cases with single polyp, polyps were removed by direct excision in 8 cases, proctosigmoidoscopic or colonoscopic polypectomy in 36 cases, operative polypectomy in 10 cases, spontaneous expulsion of polyp in 4 cases, and conservative treatment in 2 cases. Of 9 cases with multiple polyps, proctosigmoidoscopic or operative polypectomy for pathologic diagnosis was done in 2 cases respectively, operative polypectomy in combination with endoscopic polypectomy in 3 cases, and conservative treatment in 4 cases.

Keywords :Polyp; Gastrointestinal bleeding.