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Julio Alejandro Murra-Saca MD.
Gastroenterologist, Coloproctologist
Tel : (503) 2226-3131, (503) 2225-3087, Celular (503) 7887-2507
Email
   
Edificio Centro Scan, Colonia Médica, San Salvador, El Salvador.

 

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Notes on Cyber Gastroenterology

 
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.

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


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.

For more endoscopic details please download the video clip  by clicking on the image
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.

 

For more endoscopic details please download the video clip  by clicking on the image
Large polyp at transvers colon

 

 





 

For more endoscopic details please download the video clip  by clicking on the image
Transvers colon

 



 




 

 

 

For more endoscopic details please download the video clip  by clicking on the image


 

 

 

For more endoscopic details please download the video clip  by clicking on the image
Ileocecal valve at 3 years of age.

 

 

 

 

 

For more endoscopic details please download the video clip  by clicking on the image
Large polypectomy

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