Juvenile
polyps are the most common
tumors of the gastrointestinal tract in children and are the principal cause of
hematochezia. A total of 103 children and adolescents with
intestinal polyps have been treated in Veterans General Hospital-Taipei from March 1961 to March 1994. The diagnosis included 87 cases (84.5%) of juvenile
polyps, 2 cases of isolated
adenomatous polyp and 14 cases of inherited polyposis syndrome. Juvenile
polyps most often occur in children between 2 to 10 years old, with a male-to-female ratio of 1.4:1. Rectal
bleeding was the main symptom (97.7%). Of the 87 patients, 82.8% had isolated
polyps and 83.3% of those were located in rectosigmoid colon. After extensive use of colonoscopy, the reported incidence of multiple
polyps substantially increased, and more
polyps were found proximal to the rectosigmoid colon. Most juvenile
polyps were removed by colonoscopic polypectomy. The recurrent rate was 10.2%. One of the two cases of
juvenile polyposis coli suffered from
intussusception demanding partial
colectomy. Recurrent
polyps were found in the remaining colon and were removed by colonoscopic polypectomy. Seven patients of
Peutz-Jeghers syndrome came from five families. At initial diagnosis, one case had no
polyps and two presented with
intussusception. A 19-year-old girl was found to have bilateral
ovarian cysts. One of the three
familial adenomatous polyposis had
adenocarcinoma at initial evaluation. Two cases of
Gardner's syndrome received
sulindac treatment, and no evidence of
malignancy was found after three years of follow-up.