Juvenile Polyps

Key Features

• Usually pedunculated and solitary

• Head of the polyp is composed of hyperplastic glandular and vascular elements, often with cystic transformation

• Benign and 80% occur in the rectosigmoid

• Incidence is highest between ages 3 and 5 years

Clinical Findings

• Painless passage of small amounts of bright red blood with mucus on a normal or constipated stool

• Abdominal pain is rare

• Low-lying polyps may prolapse during defecation

Diagnosis

• Colonoscopy is diagnostic and therapeutic when polyps are suspected

• After removal of the polyp by electrocautery, nothing further should be done if histologic findings confirm the diagnosis

• Juvenile polyps may be present in the colon, causing anemia, diarrhea with mucus, and protein loss

• Juvenile polyposis syndrome may be diagnosed if there are

  • More than five juvenile polyps in the colon

  • Multiple juvenile polyps elsewhere in the GI tract

  • Any number of juvenile polyps as well as a family history of juvenile polyposis syndrome

Treatment

• Routine cancer surveillance