Endoscopic Findings in Children with Isolated Lower Gastrointestinal Bleeding
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Background/Aims: Colorectal polyps are a common cause of lower gastrointestinal bleeding in children. Our aim was to study thecauses of isolated lower gastrointestinal bleeding and to analyze the characteristics of the colorectal polyps found in our cohort. Methods: We retrospectively reviewed colonoscopic procedures performed between 2007 and 2015. Children with isolated lowergastrointestinal bleeding were included in the study. Results: A total of 185 colonoscopies were performed for isolated lower gastrointestinal bleeding. The median patient age was 8 years,and 77 patients (41.6%) were found to have colonic polyps. Normal colonoscopy findings were observed and acute colitis was detectedin 77 (41.6%) and 14 (7.4%) patients, respectively. Single colonic polyps and 2–3 polyps were detected in 73 (94.8%) and 4 (5.2%) patientswith polyps, respectively. Of the single polyps, 69 (94.5%) were juvenile polyps, among which 65 (94.2%) were located in the left colon. Conclusions: Single left-sided juvenile polyps were the most common cause of isolated lower gastrointestinal bleeding in our study. Itwas rare to find multiple polyps and polyps proximal to the splenic flexure in our cohort. A full colonoscopy is still recommended in allpatients in order to properly diagnose the small but significant group of patients with pathologies found proximal to the splenic flexure.
Abstract
Background/Aims: Colorectal polyps are a common cause of lower gastrointestinal bleeding in children. Our aim was to study thecauses of isolated lower gastrointestinal bleeding and to analyze the characteristics of the colorectal polyps found in our cohort. Methods: We retrospectively reviewed colonoscopic procedures performed between 2007 and 2015. Children with isolated lowergastrointestinal bleeding were included in the study. Results: A total of 185 colonoscopies were performed for isolated lower gastrointestinal bleeding. The median patient age was 8 years,and 77 patients (41.6%) were found to have colonic polyps. Normal colonoscopy findings were observed and acute colitis was detectedin 77 (41.6%) and 14 (7.4%) patients, respectively. Single colonic polyps and 2–3 polyps were detected in 73 (94.8%) and 4 (5.2%) patientswith polyps, respectively. Of the single polyps, 69 (94.5%) were juvenile polyps, among which 65 (94.2%) were located in the left colon. Conclusions: Single left-sided juvenile polyps were the most common cause of isolated lower gastrointestinal bleeding in our study. Itwas rare to find multiple polyps and polyps proximal to the splenic flexure in our cohort. A full colonoscopy is still recommended in allpatients in order to properly diagnose the small but significant group of patients with pathologies found proximal to the splenic flexure.
참고문헌 (14)
- Torres P, "The usefulness of endoscopic polypectomy of rectosigmoid and colon in childhood", G E N, 45, pp.51~54 (1991)
- El-Shabrawi MH, "Colorectal polyps : a frequently-missed cause of rectal bleeding in Egyptian children", Ann Trop Paediatr, 31, pp.213~218 (2011)
- Hye Jin Lee, "Is Colonoscopy Necessary in Children Suspected of Having Colonic Polyps?", Gut and Liver, 4(3), pp.326~331 (2010), 거트앤리버 소화기연관학회협의회
- Thakkar K, "Colorectal polyps in childhood", Curr Opin Pediatr, 24, pp.632~637 (2012)
- Lin CH, "Colonoscopic polypectomy of colorectal polyps in children under general anesthesia", Kaohsiung J Med Sci, 25, pp.70~76 (2009)
- Mandhan P, "Sigmoidoscopy in children with chronic lower gastrointestinal bleeding", J Paediatr Child Health, 40, pp.365~368 (2004)
- Sahn B, "Lower gastrointestinal bleeding in children", Gastrointest Endosc Clin N Am, 26, pp.75~98 (2016)
- Haghi Ashtiani MT, "Colorectal polyps : a clinical, endoscopic and pathologic study in Iranian children", Med Princ Pract, 18, pp.53~56 (2009)
- Tam YH, "Colonoscopy in Hong Kong Chinese children", World J Gastroenterol, 16, pp.1119~1122 (2010)
- Brugnara C, "Nathan and Oski’s hematology of infancy and childhood", pp.455~520 (2009), WB Saunders
- Fox VL, "Juvenile polyps: recurrence in patients with multiple and solitary polyps", Clin Gastroenterol Hepatol, 8, pp.795~799 (2010)
- Poddar U, "Colonic polyps : experience of 236 Indian children", Am J Gastroenterol, 93, pp.619~622 (1998)
- Campbell AM, "Does painless rectal bleeding equate to a colonic polyp", Arch Dis Child, 102, pp.1049~1051 (2017)
- Kleinman RE, "Walker’s pediatric gastrointestinal disease" (2018), People’s Medical Publishing House USA