Juvenile polyp in children in Kano Nigeria: Clinical presentation and management challenges

Background: Juvenile polyps are a common cause of low volume painless rectal bleeding in children. Most of these polyps are located within the sigmoid colon and the rectum. Objective: The aim of this study was to describe the clinical characteristics of children presenting with colorectal polyp in Kano, Nigeria and to document the challenges faced in their management. Materials and Methods: We undertook a retrospective review of the clinical records of all children aged 13 years or less who presented to our hospital with a colorectal polyp between January 2008 and December 2008, and also prospectively enrolled all those presenting between January 2009 and December 2010. Demographic, clinical and laboratory data were collected. Data were analysed using SPSS 15.0 (SPSS Inc, Chicago, IL). Results: There were 16 patients in all, with their ages ranging between 2.5 years and 9 years (mean 6.03 years). There were 8 boys and 8 girls (M: F = 1:1). Haematochezia was the most common presenting symptom, followed by a prolapsing rectal mass and rectal prolapse. In 13 of the patients, there was a solitary polyp, while 3 patients had 2 polyps each. All the polyps were located in the rectum within 7 cm of the anal verge. Only one patient had a sessile polyp, while all the others were pedunculated. Histopathology reported juvenile polyp without evidence of adenomatous change in all of them. Conclusion: A careful digital rectal examination is recommended for all children presenting with a bloody stool to rule out juvenile polyp.