Pillai R B, Tolia V
Division of Gastroenterology, Wayne State University School of Medicine, Detroit, MI, USA.
Clin Pediatr (Phila). 1998 Apr;37(4):253-7. doi: 10.1177/000992289803700406.
A retrospective chart review on 77 children and adolescents (45 males and 32 females) with colorectal polyps seen over a 15-year period (1980-1994) was undertaken. Their presenting symptoms, demographic data, methods of diagnosis, pathologic diagnosis, and outcome were assessed. The age at presentation varied from 6 months to 19 years (mean age 77 months), 66.2% presenting under 6 years of age. The presenting symptoms were rectal bleeding in 71 patients, mass per rectum in 12, abdominal pain in nine, diarrhea in nine, vomiting in two, and one patient was asymptomatic. Air contrast barium enema was confirmatory in 41/54 patients (76%). Polyps were palpable in 16 patients during the rectal examination. A single polyp was present in 50 patients, whereas two to five polyps were present in 20 patients, and more than five in seven patients. Successful endoscopic removal was accomplished in 71/73 patients (97.3%). In 83.1% of patients polyps were located in the rectosigmoid area and in 32.5% polyps occurred proximal to the sigmoid colon. However, multiple polyps in the same location or at other locations were also present simultaneously. Recurrence was observed in five of 63 patients (7.9%) with juvenile polyps, in one patient with infantile polyposis, and in one with solitary adenomatous polyp. We conclude that a full colonoscopic evaluation should be performed in all patients with suspected polyps if feasible, for multiple polyps occurred in 35% of children without polyposis syndromes in this series. Parents of patients with more than three polyps and/or a family history of juvenile polyposis should be warned regarding the possibility of an increased risk of malignancy in future if polyps continue to recur.
对1980年至1994年这15年间诊治的77例结直肠息肉患儿及青少年（45例男性，32例女性）进行了回顾性病历分析。评估了他们的就诊症状、人口统计学数据、诊断方法、病理诊断及转归情况。就诊年龄从6个月至19岁不等（平均年龄77个月），66.2%的患者年龄小于6岁。就诊症状包括：71例直肠出血、12例直肠肿物、9例腹痛、9例腹泻、2例呕吐，1例无症状。气钡双重造影对54例中的41例（76%）具有确诊意义。直肠指检时16例可触及息肉。50例患者为单个息肉，20例患者有2至5个息肉，7例患者息肉超过5个。73例患者中的71例（97.3%）成功进行了内镜下切除。83.1%的患者息肉位于直肠乙状结肠区域，32.5%的患者息肉位于乙状结肠近端。然而，同一部位或其他部位也可同时存在多个息肉。63例幼年性息肉患者中有5例（7.9%）复发，1例婴儿型息肉病患者复发，1例孤立性腺瘤性息肉患者复发。我们得出结论：如果可行，所有疑似息肉的患者均应进行全结肠镜评估，因为本系列中35%无息肉病综合征的儿童存在多个息肉。对于息肉超过3个和/或有幼年性息肉病家族史的患者家长，应告知如果息肉持续复发，未来发生恶性肿瘤的风险可能增加。
