García de Dávila M T, Marín A
Hospital Nacional de Pediatría P. Garraham, Argentina.
Acta Gastroenterol Latinoam. 1990;20(4):205-10.
From 1965 to 1987, 230 polypectomies were performed in patients between 8 month to 16 years old, 147 boys and 83 girls. The most frequent symptom was rectal bleeding and the most frequent location was the rectosigmoid (96%). The polyps measured from 0.8 to 2 cm., in only one case the polyp measured more than 5 cm. causing duodenal obstruction and it was associated with a gastric polyp. Solitary polyps represented 93.9% of all cases, Peutz-Jeghers syndrome 1.73 and juvenile polyposis 0.87%. In that period 3 cases of colonic carcinoma in children over 9 years old were diagnosed. The histology of 200 polyps were reviewed. In 21 cases the diagnosis was modified (10.5%). The juvenile polyp (J.P.) was the most frequent type (93%). The usual histopathological pattern was observed in 71.5% of the J.P., early lesions (26.3%) and hyperplastic changes (2.1%). Six cases were tubular adenoma and one tubulovillous. The multiple juvenile polyposis was found in girls (13 and 14 years old). None of the patients with Peutz-Jeghers syndrome had gonadal tumor. Endoscopic polypectomy in children is a safe and effective treatment for colorectal polyps. This study provides information on the clinicopathologic findings in argentinian children with intestinal polyps treated by polypectomy over a 22 year period. It emphasizes that juvenile polyps is the most frequent pattern however other lesions can be present in gastrointestinal tract and also associated with others tumors. Patients with polyps should be followed at regular intervals which can be modified according to the histologic type and family history.
1965年至1987年期间,对年龄在8个月至16岁之间的患者进行了230例息肉切除术,其中男孩147例,女孩83例。最常见的症状是直肠出血,最常见的部位是直肠乙状结肠(96%)。息肉大小从0.8厘米至2厘米不等,仅1例息肉超过5厘米,导致十二指肠梗阻,且与胃息肉相关。孤立性息肉占所有病例的93.9%,佩-吉综合征占1.73%,幼年性息肉病占0.87%。在此期间,诊断出3例9岁以上儿童患结肠癌。回顾了200例息肉的组织学情况。21例(10.5%)诊断被修正。幼年性息肉(J.P.)是最常见的类型(93%)。在71.5%的幼年性息肉中观察到常见的组织病理学模式,早期病变占26.3%,增生性改变占2.1%。6例为管状腺瘤,1例为管状绒毛状腺瘤。在女孩(13岁和14岁)中发现了多发性幼年性息肉病。佩-吉综合征患者均未发生性腺肿瘤。儿童内镜下息肉切除术是治疗结直肠息肉的一种安全有效的方法。本研究提供了关于阿根廷22年间接受息肉切除术治疗的肠息肉儿童的临床病理结果的信息。它强调幼年性息肉是最常见的模式,然而胃肠道中也可能存在其他病变,并且还可能与其他肿瘤相关。息肉患者应定期随访,随访间隔可根据组织学类型和家族史进行调整。