title: Nonfamilial juvenile polyposis coli manifesting as massive lower gastrointestinal hemorrhage: report of two cases.
abstract: Juvenile polyposis syndrome is an uncommon hamartomatous disorder with gastrointestinal (GI) manifestations of varying degree and malignant potential. We report the cases of an 8-year-old girl and a 5-year-old girl who suffered massive lower GI hemorrhage. Neither patient had a family history of polyposis. After the patients were stabilized, radiological evaluation, laparotomy, and intraoperative colonoscopy revealed multiple polyps in the colon. Both patients underwent total colectomy, mucosal proctectomy, and ileoanal anastomosis. The diagnosis of nonfamilial juvenile polyposis was based on the histological findings and the absence of a family history. To our knowledge, this presentation of juvenile polyposis has been reported only twice before. We discuss the clinical features and diagnosis of juvenile polyposis and the treatment options. Although juvenile polyposis is a rare condition in children, it should be considered in the differential diagnosis of life-threatening GI hemorrhage.
authors.affiliation: Department of Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: Akshay
authors.initials: A
authors.lastname: Pratap
authors.forename: Awadhesh
authors.initials: A
authors.lastname: Tiwari
authors.forename: Arvind Kumar
authors.initials: AK
authors.lastname: Sinha
authors.forename: Anand
authors.initials: A
authors.lastname: Kumar
authors.forename: Sudeep
authors.initials: S
authors.lastname: Khaniya
authors.forename: Rajat Kumar
authors.initials: RK
authors.lastname: Agarwal
authors.forename: Vikal Chandra
authors.initials: VC
authors.lastname: Shakya
mesh_terms: D002648:Child; D002675:Child, Preschool; D003082:Colectomy; D003111:Colonic Polyps / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D044483:Intestinal Polyposis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery