A Case of Jejunal Juvenile Polyp Presented as Intussusception

장중첩증 증상을 보인 공장에 발생한 연소성 용종 1례

  • Kwon, Ki Beom (Department of Pediatrics, College of Medicine, Soonchunhyang University) ;
  • Shin, Mee Yong (Department of Pediatrics, College of Medicine, Soonchunhyang University) ;
  • Kwon, Kye Won (Department of Pathology, College of Medicine, Soonchunhyang University) ;
  • Park, Jae Ock (Department of Pediatrics, College of Medicine, Soonchunhyang University)
  • 권기범 (순천향대학교 의과대학 소아과학교실) ;
  • 신미용 (순천향대학교 의과대학 소아과학교실) ;
  • 권계원 (순천향대학교 의과대학 병리학교실) ;
  • 박재옥 (순천향대학교 의과대학 소아과학교실)
  • Received : 2004.11.19
  • Accepted : 2005.01.13
  • Published : 2005.04.15

Abstract

Single or scattered sequential hamartomatous juvenile polyps are common in the large intestine, especially the rectosigmoid area, where they are usually nonfamilial. Juvenile polyps arising in the small inestine are very rare. Juvenile polyps are usually found in children aged between 1 and 10 years, the majority of cases are between 2 and 4 years of age. Bleeding is the most common symptom, but some children may suffer from autoamputation or prolapse through the anus, and rare cases are presented as intussusception. Approximately six cases of juvenile polyps in the small bowel have been reported. Jejunal intussusception arising from juvenile polyp is uncommon in comparison with the ileocolic form. It has an atypical subacute presentation. It must be better understood for its diagnosis can be made too late. Surgical exploration is the treatment of choice because of the recurrence of various clinical symptoms. We report a case of single juvenile polyp of jejunum found in a 10-year-old girl who presented with signs of intussusception.

연장아에게서 장중첩증의 소견을 보일 경우 원인 질환이 있는지 의심해야 하며, 원인 질환을 찾도록 노력하여야 한다. 저자들은 심와부 통증과 구토로 내원한 10세 여아에게서 장중첩증으로 발현된 공장에 발생한 연소성 용종 1례를 경험하였다.

Keywords

References

  1. Horrilleno EG, Eckert C, Ackerman LV. Polyps of the rectum and colon in children. Cancer 1957;10:1210-20 https://doi.org/10.1002/1097-0142(195711/12)10:6<1210::AID-CNCR2820100619>3.0.CO;2-2
  2. Roth SI, Helwig EB. Juvenile polyps of the colon and rectum. Cancer 1963;16:468-79 https://doi.org/10.1002/1097-0142(196304)16:4<468::AID-CNCR2820160408>3.0.CO;2-F
  3. Lowichik A, Jackson WD, Coffin CM. Gastrointestinal polyposis in childhood : clinicopathologic and genetic features. Pediatr Dev Pathol 2003;6:371-91 https://doi.org/10.1007/s10024-002-0701-x
  4. Sachatello CR, Hahn IS, Carrington CB. Juvenile gastrointestinal polyposis in a female infant : report of a case and review of the literature of a recently recognized syndrome. Surgery 1974;75:107-14
  5. Grigioni WF, Alampi G, Martinelli G, Piccaluga A. Atypical juvenile polyposis. Histopathology 1981;5:361-76 https://doi.org/10.1111/j.1365-2559.1981.tb01798.x
  6. Zimmermann H, Stauch G, Kamran D. Juvenile polyp in the small bowel. Z Kinderchir 1981;33:89-93
  7. Garcia JM, Martin PF, Dominguez VJ. Intestinal polyp of infrequent localization : presentation of 2 cases. An Esp Pediatr 1984;21:855-7
  8. Sah SP, Agrawal CS, Jha PC, Rani S. Juvenile polyps in the small intestine presenting as jejunojejunal intussusception in a 10 year old child : report of a case. Surg Today 2002;32:828-30 https://doi.org/10.1007/s005950200160
  9. Conte G, Tornotti G, Sordo S. An atypical case of juvenile polyps. Pediatr Med Chir 1991;13:215-6
  10. Chavanis N, Boumahni B, Jacquier C, Piolat C, Leroux F, Dyon JF. An unusual case of inestinal invagination : jejunojejunal invagination. Arch Pediatr 1999;6:530-2 https://doi.org/10.1016/S0929-693X(99)80559-4
  11. Moon TI, Jeong YC, Chae KM. Intussusception due to jejunal polyp. J Korean Surg Soc 1985;29:349-52
  12. Julissa C, Jennifer W, John B. Gastrointestinal polyps in children : advances in molecular genetics, diagnosis, and management. J Pediatr 2001;138:621-8 https://doi.org/10.1067/mpd.2001.113619
  13. Diamond M. Adenoma of the rectum in children. Am J Dis Child 1939;57:360
  14. Mazier WP, MacKeigan JM, Billingham RP, Dignan RD. Juvenile polyps of the colon and rectum. Surg Gynecol Obstet 1982;154:829-32
  15. Dajani YF, Kamal MF. Colorectal juvenile polyps : an epidemiological and histopathological study of 144 cases in Jordanians. Histopathology 1984;8:765-79 https://doi.org/10.1111/j.1365-2559.1984.tb02393.x
  16. Goodman ZD, Yardley JH, Milligan FD. Pathogenesis of colonic polyps in multiple juvenile polyposis : report of a case associated with gastric polyps and carcinoma of the rectum. Cancer 1979;43:1906-13 https://doi.org/10.1002/1097-0142(197905)43:5<1906::AID-CNCR2820430548>3.0.CO;2-O
  17. Beacham CH, Shields HM, Raffensperger EC, Enterline HT. Juvenile and adenomatous gastrointestinal polyposis. Am J Dig Dis 1978;23:1137-43
  18. Rabin ER, Patel TP, Chen FH, Gunalp S, Brown HW. Juvenile colonic polyposis with villous adenoma and retroperitoneal fibrosis : report of a case. Dis colon Rectum 1979; 22:63-7 https://doi.org/10.1007/BF02586762
  19. Morson BC. Some peculiarities in the history of intestinal polyps. Dis Colon Rect 1962;5:337 https://doi.org/10.1007/BF02616584
  20. McColl I, Busxey JH, Veale AM, Morson BC. Juvenile polyposis coli. Proc R Soc Med 1964;57:896-7
  21. Scharf GM, Becker JH, Laage NJ. Juvenile gastrointestinal polyposis or the infantile Cronkhite-Canada syndrome. J Pediatr Surg 1986;21:953-4 https://doi.org/10.1016/S0022-3468(86)80102-6
  22. Nicholls S, Smith V, Davies R, Doig C, Thomas A, Miller V. Diffuse juvenile non-adenomatous polyposis : a rare cause of severe hypoalbuminemia in childhood. Acta Paediatr 1995;84:1447-8 https://doi.org/10.1111/j.1651-2227.1995.tb13590.x
  23. Nugent KP, Talbot IC, Hodgson SV, Philips RK. Solitary juvenile polyps : not a marker for subsequent malignancy. Gastroenterology 1993;105:698-700