Malignant risk in juvenile polyposis coli: increasing documentation in the pediatric age group.

Abstract:

:The presence of juvenile polyps with resulting bleeding and abdominal pain has traditionally been considered a benign, self-limiting process which would resolve with age. The dictum that these polyps were usually solitary, were found predominantly in the rectosigmoid area, and were without malignant potential has been reconsidered in recent years with the increased use of colonoscopy. Several case reports in both adults and children have documented the presence of adenomatous changes in this syndrome. We report 3 cases of children, ages 3, 11, and 11 who were found to have adenomatous polyps in the midst of fields of juvenile polyps on evaluation for rectal bleeding. All three were treated definitively with endorectal pull-through. Two of these patients had atypia on histological evaluation, one of which was severe. We recommend a more aggressive approach to patients found to have multiple juvenile polyps on barium enema, including colonoscopic biopsies at several sites to determine the presence of adenomatous changes, with colectomy and endorectal pull-through should these be found.

journal_name

J Pediatr Surg

authors

Heiss KF,Schaffner D,Ricketts RR,Winn K

doi

10.1016/0022-3468(93)90162-e

subject

Has Abstract

pub_date

1993-09-01 00:00:00

pages

1188-93

issue

9

eissn

0022-3468

issn

1531-5037

pii

0022-3468(93)90162-E

journal_volume

28

pub_type

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