COLONIC POLYPS - EXPERIENCE OF 236 INDIAN CHILDREN

Objectives: We studied the clinical spectrum, histology, and malignant potential of colonic polyps in Indian children (less than or equal to 12 yr), Methods: Two hundred thirty-six children with colonic polyps were studied from January 1991 to October 1996., They were evaluated c linically and colonoscopic polypectomy was done, Children with five or more juvenile polyps were labeled as having juvenile polyposis and se rial colonoscopic polypectomies were done every 3 wk, Colectomy was pe rformed when there were intractable symptoms or clearing of the polyps by colonoscopy was not possible. Histological examination of the poly ps was done. Follow-up colonoscopy was done in children with juvenile polyposis only. Results: The mean age of these children was 6.12 +/- 2 .7 yr, with a male preponderance (3.5:1), Rectal,bleeding of a mean du ration of 14 +/- 16 months was the presenting symptom in 98.7%, Solita ry polyps were seen in 76%, multiple polyps in 16.5%, and juvenile pol yposis in 7% (n = 17) of the children. A majority (93%) of the polyps were juvenile and 85% were rectosigmoid in location. Adenomatous chang es, seen in 11%, were more common in juvenile polyposis (59%) than in juvenile polyps (5%), Among those with juvenile polyposis, colon clear ance was achieved in eight, six required colectomy for intractable sym ptoms, and three were still on the polypectomy program. Polyps recurre d in 5% of children with juvenile polyps and 37.5% of those with juven ile polyposis. Conclusions: Juvenile polyps remain the most common col onic polyps in children. A significant number of cases of polyps are m ultiple and proximally located, which emphasizes the need for total co lonoscopy in all. Juvenile polyps should be removed even if asymptomat ic because of their neoplastic potential, Colonoscopic polypectomy is effective even in juvenile polyposis. Surveillance colonoscopy is requ ired in juvenile polyposis only. (C) 1998 by Am. Cell. of Gastroentero logy.