Poddar U, Thapa B R, Vaiphei K, Rao K L, Mitra S K, Singh K
Department of Gastroenterology, Pathology and Paediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Arch Dis Child. 1998 Mar;78(3):264-6. doi: 10.1136/adc.78.3.264.
The clinical profile, malignant potential, and management of 17 children with juvenile polyposis (more than five juvenile polyps) were evaluated clinically and endoscopically. Colonoscopy and polypectomy were done three weekly until colonic clearance was achieved, and thereafter two yearly. All polyps were subjected to histological examination. Mean age was 7.7 years, with a male preponderance (3:1). Presentation was with rectal bleeding (94%), pallor (65%), stunted growth (53%), and oedema (47%), and the mean (SD) duration of symptoms was 33 (27) months. None had a positive family history or any congenital anomaly. Two children had six polyps up to the transverse colon; the rest had numerous polyps all over the colon. All children had juvenile polyps on histology and 10 (59%) had adenomatous changes (dysplasia). Total colectomy was done in six for intractable symptoms. Colon clearance was achieved in eight after an average 3.4 polypectomy sessions, and three were still on the polypectomy programme. In conclusion, juvenile polyposis is commonly associated with low grade dysplasia. Serial colonoscopic polypectomy is effective but colectomy is required for intractable symptoms and when clearance of the colon is not possible.
对17例患有幼年性息肉病（超过5个幼年性息肉）的儿童的临床特征、恶性潜能及治疗进行了临床和内镜评估。每三周进行一次结肠镜检查及息肉切除术，直至结肠息肉清除，此后每两年进行一次。所有息肉均进行组织学检查。平均年龄为7.7岁，男性居多（3:1）。临床表现为直肠出血（94%）、面色苍白（65%）、生长发育迟缓（53%）和水肿（47%），症状平均（标准差）持续时间为33（27）个月。无一例有阳性家族史或任何先天性异常。2例儿童横结肠有6个息肉；其余儿童结肠内有大量息肉。所有儿童组织学检查均为幼年性息肉，10例（59%）有腺瘤样改变（发育异常）。6例因症状难以控制而行全结肠切除术。8例平均经过3.4次息肉切除术后结肠息肉清除，3例仍在进行息肉切除术。总之，幼年性息肉病常伴有低度发育异常。连续结肠镜下息肉切除术有效，但对于症状难以控制及无法清除结肠息肉的情况则需要进行结肠切除术。
