JUVENILE POLYPOSIS IN A TROPICAL COUNTRY

The clinical profile, malignant potential, and management of 17 childr en with juvenile polyposis (more than five juvenile polyps) were evalu ated clinically and endoscopically. Colonoscopy and polypectomy were d one three weekly until colonic clearance was achieved, and thereafter two yearly. All polyps were subjected to histological examination. Mea n age was 7.7 years, with a male preponderance (3:1). Presentation was with rectal bleeding (94%), pallor (65%), stunted growth (53%), and o edema (47%), and the mean (SD) duration of symptoms was 33 (27) months . None had a positive family history or any congenital anomaly. Two ch ildren had six polyps up to the transverse colon; the rest had numerou s polyps all over the colon. All children had juvenile polyps on histo logy and 10 (59%) had adenomatous changes (dysplasia). Total colectomy was done in six for intractable symptoms. Colon clearance was achieve d in eight after an average 3.4 polypectomy sessions, and three were s till on the polypectomy programme. In conclusion, juvenile polyposis i s commonly associated with low grade dysplasia. Serial colonoscopic po lypectomy is effective but colectomy is required for intractable sympt oms and when clearance of the colon is not possible.