Sonographic diagnosis of colorectal polyps in children

Abstract

This study was established to evaluate the diagnostic value of ultrasonography in screening colorectal polyps in children and to discuss the necessity of colonic preparation before an ultrasonic examination.In this study, 288 children with colorectal polyps managed at our hospital between January 2007 and December 2016 were retrospectively reviewed. All patients were examined before and after basic colon preparation. The colorectal polyps were confirmed by colonoscopy/laparotomy and histopathology. Among all 288 patients, solitary polyps were identified in 278 patients (96.52%), and multiple polyps were identified in 10 patients (43 polyps) (3.48%) by colonoscopy/laparotomy and histopathology.By ultrasonic examination, 264 cases (264/278) were detected as solitary polyp and 9 cases (9/10) as multiple polyps (31 polyps). In 278 solitary polyps, 180 (64.74%) were detected by ultrasonic examination without a colon preparation. Following glycerine enema (10–20 mL) treatment, 264 (94.96%) cases were detected by ultrasonic examination. The sensitivity and specificity of ultrasonography with glycerine enema for the detection of colorectal polyps were 94.96% and 100%, respectively. Colon preparation significantly increased the proportion of polyps identified by ultrasonography (P < .0001), as well as the diagnostic rate of polyps in rectum, sigmoid colon and descending colon (P < .05).Ultrasonography can be the primary diagnostic method for screening colorectal polyps in children on the strength of its safety, validity, and accuracy. Basic colon preparation with glycerine enema is recommended for children, which enable the detection of intraluminal lesions before ultrasonic examination.

Successful detection and removal of predictable juvenile polyp: a case report

“…Therefore, it is helpful to the operator to accurately predict the presence of juvenile polyp before the procedure and to perform a colonoscopy in a state where the exact location is known. For this reason, abdominal ultrasonography is recently recognized as a primary test for high safety and accuracy as a screening for juvenile polyp in children [ 13 ]. In the case of juvenile polyp, they are commonly located in the left lower colon and rectum [ 4 , 5 ].…”

“…The causes of false negatives include the operator’s skill level, relatively small polyp size, and polyps located in the rectum [ 14 ]. According to Qu et al [ 13 ], when enema is performed before abdominal ultrasonography, the polyp detection rate reaches up to 97%. Because our patient did not perform enema prior to ultrasonography, the entire colon including the rectum was evaluated precisely during endoscopy, but there were no additional polyps.…”

Características clínicas e incidencia de pólipos colónicos en niños durante una década

“…1 también realizaron colonoscopia por pólipos en 4 lactantes de 1 año (8.2%), lo cual no es usual en niños tan pequeños, y consideran que pueden observarse de manera esporádica. Los pólipos gastrointestinales están comúnmente presentes durante primera infancia entre los 2 y 5 años, generalmente se manifiesta con sangrado rectal indoloro, pólipos benignos, se limitan al colon y a la histología son pólipos juveniles 19 , como lo observado en este estudio y otros en la literatura [20][21] .…”