Juvenile polyps and their distribution in pediatric patients with gastrointestinal bleeding.

Juvenile polyps (JPs) are the most common colonic tumor in childhood. The total number and anatomical distribution have changed significantly since the introduction of flexible colonoscopy. This article reviews our experiences treating 29 pediatric patients with JPs, and evaluates the 66 polyps we removed and their distribution in the colon. Thirteen patients (45%) had multiple polyps and 35% of all polyps were found proximal to the sigmoid colon. In the 14 patients who underwent a complete colonoscopy, eight had multiple polyps and 55% of these polyps were found proximal to the sigmoid colon. As a result, we conclude that there is a trend toward more polyps per patient and a more distal colonic distribution in children with JPs than previously reported. We recommend that a complete colonoscopy and possible polypectomy be performed on all children with unexplained rectal bleeding.