Kocaeli Med J. 2024; 13(1): 35-40 | DOI: 10.5505/ktd.2024.12316

Is Rectosigmoidoscopy Sufficient in the Evaluation of Childhood Colorectal Polyps?

Sevinç Garip
Health Sciences University Adana City Training and Research Hospital Department of Child Health and Diseases, Pediatric Gastroenterology Hepatology and Nutrition Clinic, adana, Turkey.

INTRODUCTION: Gastrointestinal(GI) polyps are mucosal or submucosal lesions protruding into the lumen.They can be neoplastic or non-neoplastic and often present with painless rectal bleeding. This study emphasizes the necessity of complete colonoscopy in pediatric patients with suspected colorectal polyps.
METHODS: This retrospective study, approved by the ethics committee,included pediatric patients (6 months – 18 years) who underwent colonoscopy between January 2019 and February 2021 and were identified with polyps.Patient data were analyzed.
RESULTS: Four hundred patients underwent colonoscopy,and 58 polyps were detected.28 of the patients were male and 11 were female;the average age was 6.8years. The most common complaint was rectal bleeding with 51.2%.All patients underwent colonoscopy by the same pediatric gastroenterologist.In our study, multiple polyps were detected in 28.2%, pedunculated polyps in 46.1%,and proximal rectosigmoid colon polyps in 15.3%.All neoplastic adenomatous polyps were located proximal to the rectosigmoid region and 75% were multiple polyps.
DISCUSSION AND CONCLUSION: Of the 400 patients who underwent colonoscopy,58 polyps were detected(28 males, 11females; mean age 6.8 years).Rectal bleeding was the most common presenting complaint(51.2%).All colonoscopies were performed by the same pediatric gastroenterologist.Multiple polyps were found in 28.2% of cases, pedunculated polyps in 46.1%,and proximal rectosigmoid colon polyps in15.3%.All neoplastic (adenomatous) polyps were located proximal to the rectosigmoid region, with75% presenting as multiple polyps.
While less common in children, right-sided colorectal polyps can occur and are closely associated with neoplasia. Therefore, in pediatric patients with suspected colorectal polyps,complete colonoscopy by an experienced pediatric gastroenterologist is essential.This increases polyp detection rates and prevents overlooking potentially neoplastic polyps in this age group.

Keywords: child, gastroenterology, colonoscopy, colorectal polyp

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Çocukluk Çaðý Kolorektal Poliplerini Deðerlendirmede Rektosigmoidoskopi Yeterli Midir?

Sevinç Garip
Saðlýk Bilimleri Üniversitesi Adana Þehir, Eðitim ve Araþtýrma Hastanesi,Çocuk Saðlýðý ve Hastalýklarý Bilim Dalý, Çocuk Gastroenteroloji Hepatoloji ve Beslenme Kliniði, Adana, Türkiye.

GÝRÝÞ ve AMAÇ: Amaç: Gastrointestinal sistem polipleri; mukoza ve submukozadan köken alarak lümene doðru çýkýntý yapan, neoplastik ve non neoplastik olabilen, en sýk aðrýsýz rektal kanama ile ortaya çýkan bir lezyondur. Çocukluk çaðý polipleri çoðunlukla iyi huyludur ancak malignite geliþimine yol açabileceði akýlda tutulmalýdýr. Çalýþmamýzda pediatrik yaþta kolorektal polip þüphesi olan hastalarda tam kolonoskopi yapýlma gerekliliðinin vurgulanmayý amaçladýk.
YÖNTEM ve GEREÇLER: 6 ay-18 yaþ aralýðýnda olan Ocak 2019 ile Þubat 2021 tarihleri arasýnda kolonoskopi yapýlarak polip saptanan çocuk hastalar çalýþmaya dahil edildi. Hasta verileri etik kurul onayý alýndýktan sonra geriye dönük olarak analiz edildi.
BULGULAR: Dört yüz hastaya kolonoskopi yapýldý, 58 polip tespit edildi. Hastalarýn 28'i erkek, 11'i kadýndý; ortalama yaþ 6,8 idi. En sýk görülen þikayet %51.2 ile rektal kanamaydý. Tüm hastalara ayný pediatrik gastroenterolog tarafýndan kolonoskopi yapýldý. Çalýþmamýzda %28.2 oranýnda çoklu polip, %46.1 oranýnda pedinküllü ve %15.3 oranýnda proksimal rektosigmoid kolon polipleri tespit edildi. Neoplastik adenomatöz poliplerin tamamý rektosigmoid bölgenin prkoksimaline yerleþmiþti ve %75'i çoklu polipti.
TARTIÞMA ve SONUÇ: Kolorektal polipler çocuklarda sað kolonda yerleþimli polipler nadir de olsa görülebilir, neoplazi ile yakýndan iliþkili olduðu bilinmelidir. Bu nedenle kolorektal polip düþünülen çocuk hastalarda deneyimli pediatrik gastroenterolog tarafýndan tam kolonoskopi yapýlmalýdýr. Böylece polip tespit oranýný artýracak ve pediatrik yaþta neoplastik poliplerin gözden kaçmasýný önleyecektir.

Anahtar Kelimeler: çocuk, gastroenteroloji, kolonoskopi, kolorektal polip

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