HYDROSONOGRAPHY IN THE EVALUATION OF COLORECTAL POLYPS

Prewarmed saline enemas and transabdominal ultrasound (hydrosonography ) were used to evaluate 17 consecutive children with rectal bleeding b efore colonoscopy. Twelve patients with polyps were identified (10 by ultrasound, 10 by endoscopy): these included multiple hyperplastic pol yps (1), multiple polyps (1), solitary polyps (9), and pseudopolyps (1 ). Ultrasound identified 11 polyps in 10 patients, missing two patient s with small polyps less than 0.5 cm in diameter. The polyps were hype rechoic ovoid masses fixed to the colonic wall, with a stalk (7), subm ucosal infolding (5), and intraluminal floating (5). There was one fal se positive. Colonoscopy was refused by one patient and failed to reac h beyond the distal sigmoid in another following previous surgery for malrotation. Colonoscopy was superior in identifying finer mucosal det ail (colitis, ulcers, proctitis, anal fissure) and in detecting smalle r polyps (sessile polyps, hyperplastic polyps). Hydrosonography of the colon is a simple, relatively non-invasive procedure that provides an alternative, radiation-free examination of the whole colon before col onoscopy. It is complementary to colonoscopy in the management of rect al bleeding in children.