The management of colonic polyps in children: a 13-year retrospective study

Dipasquale, Valeria; Romano, Claudio; Iannelli, Mauro; Tortora, A.; Princiotta, Alessandro; Ventimiglia, Marco; Melita, G; Pallio, Socrate

doi:10.1007/s00431-021-04017-y

Cited by 5 publications

(8 citation statements)

References 23 publications

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“…There is little evidence regarding the association between polyp location and size. However, a recent study by Dipasquale et al 9 reported that right colonic polyps were significantly larger than left colonic polyps. 15 We also identified this finding.…”

Section: Discussionmentioning

confidence: 92%

“… 8 Another study reported that colorectal polyps located in the right colon were significantly larger than left colonic polyps, also emphasizing the necessity of a full colonoscopy. 9 However, to date no study has comprehensively analyzed the associations between polyp characteristics, and have derived the conclusion that a full colonoscopy is necessary based on association analyses of polyp characteristics.…”

Section: Introductionmentioning

confidence: 99%

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Associations of Polyp Characteristics in Children and Adolescents Presenting with Less Than Five Colorectal Polyps: A Full Colonoscopy Is Still Required

Kim

Choi

et al. 2022

Gut and Liver

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Background/Aims: A full colonoscopy is currently required in children and adolescents with colorectal polyps, because of their potential of neoplastic transformation and complications such as intussusception. We aimed to analyze the associations of polyp characteristics in children and adolescents with colorectal polyps. Based on these findings, we also aimed to reevaluate the necessity of conducting a full colonoscopy.Methods: Pediatric patients <18 years of age who had undergone a colonoscopic polypectomy and those with <5 colorectal polyps were included in this multicenter, retrospective study. Baseline clinicodemographics, colonoscopic and histologic findings were investigated.Results: A total of 91 patients were included. Multivariate logistic regression analysis showed that polyp size was the only factor associated with the presence of any polyps located proximal to the splenic flexure (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.28 to 4.28; p=0.007). Furthermore, polyp location proximal to the splenic flexure and sessile morphology were associated with the presence of any adenomatous polyp (OR, 8.51; 95% CI, 1.43 to 68.65; p=0.023; OR, 18.41; 95% CI, 3.45 to 173.81; p=0.002, respectively). Conclusions:In children and adolescents presenting with <5 colorectal polyps, polyp size and the presence of any adenomatous polyp were positively associated with polyp location proximal to the splenic flexure. This finding supports the necessity of a full colonoscopic exam in pediatric patients with colorectal polyps for the detection of polyps before the occurrence of complications such as intussusception or neoplastic transformation.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Associations of Polyp Characteristics in Children and Adolescents Presenting with Less Than Five Colorectal Polyps: A Full Colonoscopy Is Still Required

Kim

Choi

et al. 2022

Gut and Liver

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“…Painless bloody stool is the most common symptom of intestinal polyps in children. Most of the polyps are sporadic, isolated, and benign [ 2 , 10 ]. JPs are the most common gastrointestinal polyps diagnosed in children [ 11 ], and most JPs are hamartomatous with little malignant potential [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Secondary Colo-Colic Intussusception Caused by Giant Polyp of Sigmoid Colon in a 5-Year-Old Girl

Haizhi,

Xiaobing,

Jianrong

2023

Case Rep Gastroenterol

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Intussusception is common in infants and young children. The most common type is small intestinal intussusception or ileo-colic intussusception. Colonic intussusception is rare. Intestinal polyps, especially large polyps or multiple polyps, can cause intussusception. Here, we report a rare case of colo-colic intussusception caused by a giant juvenile polyp of sigmoid colon, and the patient achieved good clinical effect through polypectomy under colonoscopy. So, when children have colonic intussusception, the possibility of colonic polyps should be considered.

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“…Studies have found that children with colorectal polyps usually have changes in defecation [ 14 , 35 , 36 ]. The study [ 37 ] on adults showed that the prevalence and incidence of colorectal cancer and colorectal polyps were significantly higher in patients with chronic constipation, the risk of which increased with the severity of chronic constipation.…”

Section: Discussionmentioning

confidence: 99%

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

Wang,

Fang,

Huang

et al. 2023

BMC Pediatr

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Background Scarce evidence exists on pediatric colorectal polyp risk factors. This study explored the clinical manifestations, morphological and pathological characteristics of, and risk factors for pediatric colorectal polyps. Methods This retrospective case-control study included children who received colonoscopy, divided into a colorectal polyp group and a normal control group based on colonoscopy results. The risk factors for colorectal polyps in children were analyzed through logistic regression analysis. Results The mean age of children with polyps was 6.77 ± 3.44 years. Polyps were detected predominantly in males (72.9%); hematochezia was the primary clinical manifestation (80.25%). Most polyps were juvenile (88.9%) and solitary (87.7%); 50.6% were located in the rectosigmoid area. Univariate analysis showed that gender (P = 0.037), age (P < 0.001), family aggregation (P < 0.001), specific immunoglobulin E (sIgE) (P < 0.001), platelet count (P = 0.001), aspartate aminotransferase (AST) (P = 0.016), meat intake (P = 0.010), and vegetable intake (P < 0.001) were significantly associated with colorectal polyps. Age ≤ 6 years (3–6 years: OR: 26.601, 95% CI: 3.761–160.910; < 3 years: OR: 22.678, 95% CI: 1.873–274.535), positive family aggregation (OR: 3.540, 95% CI: 1.177–10.643), positive sIgE (OR:2.263, 95% CI: 1.076–4.761), and higher meat intake (OR:1.046, 95% CI: 1.029–1.063) were risk factors for pediatric colorectal polyps in logistic regression analysis. Higher vegetable intake (OR: 0.993, 95% CI: 0.986–1.000) was a protective factor against pediatric colorectal polyps. The area under the curve (AUC) of meat intake in the receiver operating characteristic (ROC) curve analysis for predicting colorectal polyps was 0.607; the best cut-off value was 92.14 g/d (P = 0.010, 95% CI: 0.527–0.687). The meat and vegetable intake combination AUC in predicting pediatric colorectal polyps was 0.781 (P < 0.001, 95% CI: 0.718–0.845). Conclusions Juvenile, solitary, and located in the rectosigmoid region polyps are most common in children. Hematochezia is the main clinical manifestation. Most polyps were, but multiple and proximally located polyps were also detected. Age ≤ 6 years, especially 3–6 years, positive family aggregation, positive sIgE, and higher meat intake are risk factors for pediatric colorectal polyps. A higher vegetable intake is a protective factor.

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The management of colonic polyps in children: a 13-year retrospective study

Cited by 5 publications

References 23 publications

Associations of Polyp Characteristics in Children and Adolescents Presenting with Less Than Five Colorectal Polyps: A Full Colonoscopy Is Still Required

Associations of Polyp Characteristics in Children and Adolescents Presenting with Less Than Five Colorectal Polyps: A Full Colonoscopy Is Still Required

Secondary Colo-Colic Intussusception Caused by Giant Polyp of Sigmoid Colon in a 5-Year-Old Girl

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

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