Martins V, Gonçalves M, Leal M J
Cirurgia Pediátrica, Hospital de Santa Maria, Lisboa.
Acta Med Port. 1995 Jun;8(6):369-72.
Colon polyps are very common in infancy, most cases are unique, seldom exceeding ten; as a rule, the treatment is endoscopic resection. The AA present a case of a severe diffuse colorectal juvenile polyposis in an 8-year-old black child, with a 4-year evolution of serious digestive bleeding, abdominal pains, anemia and hypoproteinemia. The disease scattered throughout the colon with a great density at the rectum and sigmoid level, coating fully the mucous membrane, making the classic treatment by endoscope unworkable. A resection of the rectum and descendent colon with transrectal pullthrough by the Soave technique with anal demucosization was performed. The post operative without incidents and the follow-up period was considered satisfactory. Complementary endoscopic resection of the remaining and scattered polyps followed. The result of the histopathological examination of all elements studied was juvenile polyps. This case demonstrates the necessity of surgical treatment with resection in cases of severe diffuse juvenile polyposis, in which endoscopic resection alone is not deemed to be sufficient.
结肠息肉在婴儿期非常常见，大多数病例是单发的，很少超过十个；通常，治疗方法是内镜下切除。作者报道了一例8岁黑人儿童严重弥漫性结直肠幼年性息肉病的病例，该患儿有4年严重消化道出血、腹痛、贫血和低蛋白血症的病史。病变遍布整个结肠，在直肠和乙状结肠部位密度很高，完全覆盖黏膜，使得经典的内镜治疗方法无法实施。采用Soave技术经直肠拖出并进行肛门去黏膜化，切除了直肠和降结肠。术后无并发症，随访期情况令人满意。随后对剩余散在的息肉进行了内镜下补充切除。所有送检组织的组织病理学检查结果均为幼年性息肉。该病例表明，对于严重弥漫性幼年性息肉病，单纯内镜下切除被认为不够时，手术切除治疗是必要的。
