Korean J Gastrointest Endosc > Volume 17(4); 1997 > Article

Korean Journal of Gastrointestinal Endoscopy 1997;17(4): 485-493.

원저 : 식도 위장관 ; 연소성 용종의 임상 및 내시경학적 분석 ( Original Articles : Esophagus , Stomach & Intestine ; Clinical and Endoscopic Analysis of Juvenile Polyps )

김현식, 이광렬, 박세영, 임석원, 이종균, 이철호, 유정준 (Hyun Shig Kim, Kwang Real Lee, Se Young Park, Seok Won Lim, Jong Kyun Lee, Chul Ho Lee and Jung Joon Yoo)

Abstract

Background: This study was undertaken to review cases of juvenile polyps with respect to clinical and endoscopic features.
Methods:
Of the 544 cases of colonoseopic polypectomies performed from Jan. 1 to Jan. 1997, 14 cases(2.6%) involved juvenile poiyps. Those 14 cases were analyzed with special consideration given to colonoscopic aspects.
Results:
The most common age groups were the fifth and the sixth decades, comprising 50%. There were two children below 10 years of age. Males were predominant in the ratio of 1.3:1. Rectal bleeding was the most common symptom, and 4 cases were asymptomatic. Mediumsized(6-10 mm) polyps were the most common, 7 eases(50%), and large(>1 cm) polyps were the next most common, 5 cases(35.7%). The first predilection of site was the rectum, 8 cases(57.1%); the second was the sigmoid colon with 5 cases(35.7%). Grossly, pedunculated polyps were the largest in number, accountieg for 64.3% of the cases; the others were all subpedunculated. In 9 cases(64.3%), the preoperative macroscopic diagnoses were consistent with the final diagnoses; in the other cases, the polyps were initially diagnosed as being adenomatous. Adenomatous and inflammatory polyps were associated with 3 cases, who were all men. White spots were noticed around the polyp base in 4 cases (28.6%); the clinical significance of those should be investigated further. All 14 patients underwent polypectomy by endoscopic snare resection without any complications.
Conclusions:
Colonoscopy should be the main tool for diagnosis and treatment of juvenile polyps. Juveoile polyps should be taken into account in cases of rectal bleeding and need to be differentiated from adenomatous polyps. Endoscopic polypectomy is an adequate procedure for the treatment of a solitary juvenile paiyp. (Korean J Gastrointest Endosc 17: 485-493, 1997)

Key Words: Juvenile polyp ; Rectal bleeding ; Endoscopic polypectomy ; White spots