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Right Choanal Stenosis
Joseph Junewick, MD FACR
over 7 years ago
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Juvenile Polyp with Intussusception

Case Detail

Anatomy: Gastrointestinal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Benign
Created: over 4 years ago
Updated: 10 months ago
Tags: PEDS
Modality/Study Types: US FL
Activities:
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History

Nearly 4 year old male with multiple recent intussusceptions but negative laparoscopic evaluation, now with crampy abdominal pain.


Case Images


Diagnosis

Juvenile Polyp

Findings

US – Initial image (with calipers) shows a loop of bowel with mesentery within colon.
FL – Image from pneumatic reduction shows a pedunculated mass in the proximal descending colon.
US – Post-reduction US images with Doppler show a hypervascular solid and cystic lesion with vascular pedicle.

Discussion

A juvenile polyp is a hamartoma most commonly found in the rectum in children less than 5 years of age. Polyps range in size between 1-3 cm, are often pedunculated and may contain small cystic spaces.

Symptoms are usually related to bleeding, torsion and autoamputation, or intussusception; occasionally a prolapsing rectal mass or mucopurulent stool may be noted. If found, removal is recommended because of association with dysplasia.

Solitary polyps are not associated with cancer, however removal is recommended because of the association with dysplasia. If more than 5 polyps are found, further testing for juvenile polyposis syndrome should be pursued.

Differential diagnosis of intussusception with pathologic lead point includes appendicitis and other inflamed bowel, cystic fibrosis, Meckel diverticulum, Burkitt lymphoma, Henoch-Scholein purpura.

Reference

Dunno CA. Colonic polyps in children and adolescents. Can J Gastroenterol (2007); 21(4):233-239.

Contributor

Ellen Junewick



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