Polyps

Question 1

What is the most common clinical presentation of juvenile polyps in children?

Answer 1

Painless, rectal bleeding . Up to one-third of patients can have chronic blood loss with microcytic anemia. The peak prevalence in children is between 1 and 7 years of age. The polyps are most commonly found in the rectum. Large polyps can be the lead point for intussusception.

Question 2

What are the types of colonic polyps?

Answer 2

Malignant: Polyps with cells that have lost their normal differentiation (including adenomas, some of which have ability to become cancerous)
• Hamartomatous: Benign focal malformations composed of tissue elements normally found at that site but growing in a disorganized manner
• Hyperplastic: A serrated polyp without malignant potential
• Inflammatory: Polyps associated with inflammatory bowel diseases

Question 3

Why is it important to confirm a diagnosis of juvenile polyposis?

Answer 3

Juvenile polyposis syndrome is defined by 5 or more polyps in the colon/rectum and 1 or more affected family members. This disorder is inherited in an autosomal dominant fashion. It is common (up to 12%) in patients with symptomatic polyps, especially with right colonic polyps, anemia, and adenomas rather than hamartomas. The importance of establishing a diagnosis of a polyposis syndrome is that some syndromes (e.g., Peutz-Jeghers and juvenile polyposis coli) are associated with a risk for developing adenocarcinoma , with an incidence as high as 30% in as few as 10 years after diagnosis. Another feature of Peutz-Jeghers syndrome is the presence of characteristic small, dark-colored spots (melanosis) on the lips, inside the mouth, and near the eyes and nostrils