Wiseman James, Emil Sherif
Division of Pediatric Surgery, Miller Children's Hospital, Long Beach, CA 90806, USA.
J Pediatr Surg. 2009 Sep;44(9):e9-13. doi: 10.1016/j.jpedsurg.2009.06.001.
Juvenile polyps have a reported incidence of up to 2% in individuals younger than of 18 years. Most polyps are small, occur in the distal colon and rectum, and present with bleeding or prolapse. Giant juvenile polyps have been rarely reported.
We encountered 2 unique presentations of very large juvenile polyps in children. A 9-year-old boy presented with recurrent rectal bleeding and anemia because of a single large polyp at the hepatic flexure. A 14-year-old boy presented with abdominal pain secondary to 2 large polyps in the cecum. The polyps were seen on colonoscopy as pedunculated masses larger than 5 cm and were not subjected to biopsy. Both patients underwent laparoscopic colon mobilizations with extracorporeal segmental resection in the first patient and colotomy and polypectomy in the second. Both patients had short hospital stays and excellent outcomes.
Giant juvenile polyps are rare in children and may not be amenable to colonoscopic removal. They can be resected effectively with minimal access surgical techniques.
据报道，18岁以下个体中幼年性息肉的发病率高达2%。大多数息肉较小，发生在结肠远端和直肠，表现为出血或脱垂。巨大幼年性息肉很少有报道。
我们遇到了2例儿童非常大的幼年性息肉的独特表现。一名9岁男孩因肝曲处单个大息肉出现反复直肠出血和贫血。一名14岁男孩因盲肠处2个大息肉出现腹痛。结肠镜检查时息肉表现为带蒂肿物，大于5厘米，未进行活检。首例患者接受了腹腔镜结肠游离术并体外节段性切除，第二例患者接受了结肠切开术和息肉切除术。两名患者住院时间均较短，预后良好。
巨大幼年性息肉在儿童中罕见，可能无法通过结肠镜切除。采用微创外科技术可有效切除。
