title: The clinical spectrum of duodenal polyps in pediatrics.
abstract: OBJECTIVE
  The aim of this retrospective study was to determine the prevalence, clinical presentation, and histologic subclassification of duodenal polyps identified on endoscopy (EGD) in pediatric patients.
  
  
  METHODS
  We performed an 18-year retrospective study of all pediatric patients (< 21 years) with duodenal polyps diagnosed between 1983 and 2001 at The Johns Hopkins Children's Center. Our analysis includes a formal histologic evaluation of duodenal polyps either biopsied using cold-forceps or removed by snare cautery.
  
  
  RESULTS
  Duodenal polyps were reported in 22 of 5766 EGDs (0.4%) performed in 16 (M:F; 1:1) patients with a mean (SD) age of 14.1 (5.1) years. Polyps were equal in both the Caucasian and African American population (adjusted ratio 1.2:1). The histologic subtypes included Adenomatous (42%), Brunner's gland hyperplastic (33%), hamartomatous (17%), and heterotopic gastric gland polyps (8%). The most frequent indication for EGD was surveillance in patients with polyposis syndromes; most of these patients were asymptomatic at the time of their EGD. In comparison, the most frequent indication for an EGD in patients without polyposis syndromes was abdominal pain and vomiting.
  
  
  CONCLUSIONS
  Duodenal polyps are most frequently encountered in children with polyposis syndromes, most of whom are asymptomatic. In nonsyndromic patients, the most common histologic subtype is Brunner's gland hyperplastic polyp and presenting symptoms include abdominal pain and vomiting.
authors.affiliation: Department of Pediatrics, Division of Gastroenterology and Nutrition, The Johns Hopkins Hospital, Baltimore, MD 21287-2631, USA.
authors.forename: T M
authors.initials: TM
authors.lastname: Attard
authors.forename: S C
authors.initials: SC
authors.lastname: Abraham
authors.forename: C
authors.initials: C
authors.lastname: Cuffari
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004379:Duodenal Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D004724:Endoscopy; D005260:Female; D006222:Hamartoma / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D007417:Intestinal Polyps / Q000453:epidemiology* / Q000473:pathology*; D008297:Male; D009375:Neoplasms, Glandular and Epithelial / Q000453:epidemiology* / Q000473:pathology*; D012189:Retrospective Studies