Colorectal polyps in children: a retrospective study of clinical features and the value of ultrasonography in their diagnosis

Abstract Background Colorectal polyps are common in children. The purpose of this report was to describe a clinical experience with colorectal polyps at the Beijing Children's Hospital and to evaluate the diagnostic value of ultrasonography in screening colorectal polyps in children. Method This was a retrospective medical record review of 487 children with colorectal polyps managed at the Beijing Children's Hospital between August 2003 and April 2010. Results The mean age at presentation was 4.7 ± 2.5 years, with a male predominance (M/F ratio, 1.9:1). Most children (n = 458, 94%) presented with hematochezia associated with other symptoms, such as recurrent abdominal pain (n = 42, 8.6%), prolapse of the polyp from the anus (n = 43, 8.8%), and diarrhea (n = 10, 2.1%). Anemia was observed in 33 (6.8%) children, 4 of whom required a blood transfusion before the colonoscopy. Among the 487 patients, 352 (72.3%) patients underwent ultrasonography before the colonoscopy. Polyps were detected on 345 of 352 ultrasonographic examinations in which patients subsequently underwent colonoscopy and were found to have colonic polyps. The most common polyp locations were the sigmoid colon (n = 212, 46.1%) and the rectum (n = 174, 37.8%). Solitary polyps were identified in 421 patients (88.4%), and multiple polyps were identified in 55 (11.6%) patients. Colonoscopy complications were rare, with colonic perforation observed in 2 patients and postcolonoscopy hemorrhage observed in 1 patient. The available pathology records showed that the most frequent histological type was juvenile polyps (n = 435, 91.8%), followed by Peutz-Jeghers polyps (n = 17, 3.6%), juvenile polyposis (n = 14, 3.0%), hamartomas (n = 6, 1.3%), familial adenomatous polyposis (n = 1, 0.2%), and inflammatory polyps (n = 1, 0.2%). Conclusion Ultrasonic examination is a valid, accurate, and safe technique for screening colorectal polyps in children; and a full colonoscopy should be performed to remove the polyp(s) as soon as possible.