COLONIC POLYPS IN CHILDREN - FREQUENTLY MULTIPLE AND RECURRENT

A retrospective chart review on 77 children and adolescents (45 males and 32 females) with colorectal polyps seen over a 15-year period (198 0-1994) was undertaken. Their presenting symptoms, demographic data, m ethods of diagnosis, pathologic diagnosis, and outcome were assessed. The age at presentation varied from 6 months to 19 years (mean age 77 months), 66.2% presenting under 6 years of age. The presenting symptom s were rectal bleeding in 71 patients, mass per rectum in 12, abdomina l pain in nine, diarrhea in nine, vomiting in two, and one patient was asymptomatic, Air contrast barium enema was confirmatory in 41/54 pat ients (76%). Polyps were palpable in 16 patients during the rectal exa mination. A single polyp was present in 50 patients, whereas two to fi ve polyps were present in 20 patients, and more than five in seven pat ients. Successful endoscopic removal was accomplished in 71/73 patient s (97.3%). In 83.1% of patients polyps were located in the rectosigmoi d area and in 32.5% polyps occurred proximal to the sigmoid colon. How ever, multiple polyps in the same location or at other locations were also present simultaneously. Recurrence was observed in five of 63 pat ients (7.9%) with juvenile polyps, in one patient with infantile polyp osis, and in one with solitary adenomatous polyp. We conclude that a f ull colonoscopic evaluation should be performed in all patients with s uspected polyps if feasible, for multiple polyps occurred in 35% of ch ildren without polyposis syndromes in this series, Parents of patients with more than three polyps and/or a family history of juvenile polyp osis should be warned regarding the possibility of an increased risk o f malignancy in future if polyps continue to recur.