Juvenile Polyp associated with Hypovolemic Shock Due to Massive Lower Gastrointestinal Bleeding

Abstract

Juvenile polyps are the most common types of polyps in children, and patients usually present with lower gastrointestinal (GI) bleeding as the predominant symptom. These lesions, which are referred to as hamartomas, usually measure approximately 2 cm in size and are benign tumors located mainly in the rectum and sigmoid colon. The most common symptom of a juvenile polyp is mild intermittent rectal bleeding. It is rare for anemic patients because the amount of blood loss is small and often not diagnosed immediately. We present the case of a 6-year-old girl with a juvenile polyp in the distal transverse colon, who developed hypovolemic shock due to massive lower GI bleeding. Pediatricians must perform colonoscopy for thorough evaluation of polyps, because their location and size can vary and they can cause massive bleeding.

Characteristics and risk factors for colorectal polyps among children in an urban area of Wenzhou, China: a retrospective case control study

“…Colorectal polyps consist of colonic mucosa that rises from the mucous membrane to the bowel lumen [ 1 ]. Most children with polyps have long-term painless, benign blood stools, although some have massive gastrointestinal bleeding, causing hemorrhagic shock [ 1 ].…”

“…Colorectal polyps consist of colonic mucosa that rises from the mucous membrane to the bowel lumen [ 1 ]. Most children with polyps have long-term painless, benign blood stools, although some have massive gastrointestinal bleeding, causing hemorrhagic shock [ 1 ]. According to their pathological type, colorectal polyps can be divided into juvenile, inflammatory, adenomatous, and hyperplastic polyps.…”

Potential Utility of Fecal Calprotectin in Discriminating Colorectal Polyps From Other Major Etiologies in Children Presenting With Isolated Hematochezia

“…Colorectal polyps are the most common cause of isolated hematochezia in children. 1 2 3 4 However, in clinical settings, anal fissures may also present with isolated hematochezia. Therefore, distinguishing colorectal polyps from anal fissures may often be difficult, especially when the findings of anal inspection and digital rectal exam are negative.…”