Endoscopic examination and pathology of colonic polyps in children / 临床儿科杂志

ABSTRACT

Objective To retrospectively study the results of endoscopic manifestation pathology,and treatment of colonic polyps. Methods Clinical data of 121 patients diagnosed with colonic polyps and treated by endoscopy between November 2002 and September 2009 were studied. Complete colonic investigation was done by Olympus PCF240I electron endoscopy. Colonic polyp excision was done by high frequency electric coagulation. Results All patients had bloody stool with mucus for 1 week to 8 years. Ninty four(77.7%)patients had a single polyp,6(5.0%)had two polyps,21(17.3%)with multiple polyps,and 5 patients had familial polyposis coli. The size of the polyps ranged from 0.3 cm to 4 cm and the morphology of Yamada Ⅰ to Ⅳ. The pathological changes were juvenile polyps,inflammatory polyps,polypoid formation,and canalicular adenoma. Most common pathology types were Yamada Ⅳ and juvenile polyps,107 of the 121 patients(88.4%)had juvenile polyps,and one was found to have malignant transformation. 115 patients accepted high frequency electric coagulation excision under general anesthesia,without complication. Conclusions Colonic polyp is one of the common diseases in children. Children should be checked by total colonoscopy in time when they present with bloody stool,anemia,rectal polyps prolapse or intussusception. Polypectomy under endoscope is a most safe and reliable treatment method when the diagnosis is confirmed. For isolated juvenile polyp,regular recheck is not necessary after polypectomy except when bloody stool recurs. Regular follow up by colonoscope is necessary for juvenile polyp combined with adenoma and adenomatous polyps. Colonoscope is necessary at any time when bloody stool occurs. Familial polyposis coli is difficult to be treated by endoscopy,thus surgical procedure is suggested.