title: Minimal access surgical management of large juvenile polyps in children.
abstract: BACKGROUND
  Juvenile polyps have a reported incidence of up to 2% in individuals younger than of 18 years. Most polyps are small, occur in the distal colon and rectum, and present with bleeding or prolapse. Giant juvenile polyps have been rarely reported.
  
  
  METHODS
  We encountered 2 unique presentations of very large juvenile polyps in children. A 9-year-old boy presented with recurrent rectal bleeding and anemia because of a single large polyp at the hepatic flexure. A 14-year-old boy presented with abdominal pain secondary to 2 large polyps in the cecum. The polyps were seen on colonoscopy as pedunculated masses larger than 5 cm and were not subjected to biopsy. Both patients underwent laparoscopic colon mobilizations with extracorporeal segmental resection in the first patient and colotomy and polypectomy in the second. Both patients had short hospital stays and excellent outcomes.
  
  
  CONCLUSIONS
  Giant juvenile polyps are rare in children and may not be amenable to colonoscopic removal. They can be resected effectively with minimal access surgical techniques.
authors.affiliation: Division of Pediatric Surgery, Miller Children's Hospital, Long Beach, CA 90806, USA.
authors.forename: James
authors.initials: J
authors.lastname: Wiseman
authors.forename: Sherif
authors.initials: S
authors.lastname: Emil
mesh_terms: D000293:Adolescent; D002648:Child; D003113:Colonoscopy; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery; D006801:Humans; D007417:Intestinal Polyps / Q000150:complications / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D019060:Minimally Invasive Surgical Procedures