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Juvenile Polyposis.
The most common symptom is painless rectal bleeding. Other warning
signs include polyps protruding in the rectum; slipping of one part
of the intestine into another; or malnutrition.
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| A juvenile polyp is a growth that projects from the lining
of the intestine and originates in the tissues supporting that lining.
It does not arise from the colonocytes (colonic lining cells) themselves
but from the tissues underneath the lining cells. It is not neoplastic
but hamartomatous. A hamartoma is a growth that arises from normal
tissues. It is self-limiting and benign. Juvenile polyps can be solitary
or multiple. Multiple juvenile polyps (more than five) are termed
Juvenile Polyposis. Juvenile Polyposis may or may not be familial.
Familial Juvenile Polyposis has been associated with mutations in
two genes: SMAD4 on chromosome 18 and PTEN on chromosome 10. It has
been estimated that SMAD4 mutations account for 25 percent of Juvenile
Polyposis families. Testing for mutations in this gene is only available
for research purposes. When commercially available, gene testing can
be offered to families with Juvenile Polyposis. If a mutation is found,
testing can be offered to at-risk relatives. In Juvenile Polyposis,
polyps can be found in the large intestine, the small intestine and
the stomach. Usually the colorectal polyps are the ones causing symptoms,
such as bleeding, diarrhea, abdominal cramps and anemia
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Case of juvenile polyposis with endoscopic extraction of 108 tumors.
Amonst the more unusual and interesting cases that we have encountered
is the case of a juvenile patient whom we resected 108 polyps endoscopically,
without the use of open surgery. This, to our knowledge, constitutes a
world record in itself since we have not found any other similar feat
in present world literature.
This case involves a young patient who initially came to
our clinic with a history of rectal bleeding and severe anemia, apparently
since the age of three months. Colonocopic examination revealed multiple
polyps of the colon. The patient was seen in our clinic from eleven months
to age seven and in various ( 7 ) sessions throughout this period onehundred
and eight polyps were endoscopically removed. The patients colon, which
without this procedure would have had to be removed surgically, was herewith
conserved allowing the patient to lead a normal life.
Endoscopic view of severals polyps at two years of age.
For more endoscopic details please download the video clip by clicking
on the image if you woul like to appreciate in full screen , wait to be
the video running and press Alt and Enter on the windows media.
Large polyp at transvers colon
Transvers colon
Ileocecal valve at 3 years of age.
Large polypectomy
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