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Unusual Endoscopic Findings in Children: Esophageal and Gastric Polyps

View Article: PubMed Central - PubMed

ABSTRACT

Isolated polyps of the upper digestive tract are rarely diagnosed in children, being usually an incidental finding during endoscopic exploration.

The diagnostic, therapy, and outcome of these lesions are based on endoscopy and pathology.

In a 5-year period, clinical features, topography, size, pathology, therapeutics, and progression of esophagogastric polyps founded in children addressed to our pediatric gastroenterology unit were studied.

The authors encountered 3 lesions in teenagers aged 13 to 17 years two males (2M), from a total number of 2140 upper digestive endoscopies (0.14%). All patients presented with pirosis, epigastric pain, and vomits; one of the children had end-stage renal disease and Kabuki syndrome. Endoscopic and pathologic findings were 2 esophageal polyps, an inflammatory one, and another containing goblet cells and a double-headed hyperplastic gastric polyp. Two patients received proton pump inhibitors without any improvement in subsequent endoscopic evaluations.

The difficulties related to age group, underlying conditions, debatable response to acid suppression, and limited experience in pediatric therapeutic endoscopy selected significantly the effectiveness of treatment.

The rarity of these lesions requires an individualized management, the endoscopic diagnostic, and therapeutic gesture depending on the symptoms, type, location, comorbidities, and team experience.

No MeSH data available.


Related in: MedlinePlus

Case number 3: Giant antral fold with a double-headed polyp (endoscopic image).
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Figure 3: Case number 3: Giant antral fold with a double-headed polyp (endoscopic image).

Mentions: A 15-year-old boy was admitted for epigastric pains and incoercible vomits. Medical history revealed complex pathology as Kabuki syndrome and end-stage renal disease (the patient being into a peritoneal dialysis program). Laboratory data showed very low glomerular filtration rate, moderate chronic anemia, severe azotemia, metabolic acidosis, hyperkalemia, hyperphosphatemia, and hypocalcemia. An informed consent was obtained from his parents. Endoscopy found a normally appearance of antral mucosa and a giant mucosal fold located next to the pylorus with a double-headed polyp (the heads were approximately 1–1.5 cm in size), one head on the gastric part of the fold and the other protruding intermittently into the duodenum (Figure 3).


Unusual Endoscopic Findings in Children: Esophageal and Gastric Polyps
Case number 3: Giant antral fold with a double-headed polyp (endoscopic image).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998272&req=5

Figure 3: Case number 3: Giant antral fold with a double-headed polyp (endoscopic image).
Mentions: A 15-year-old boy was admitted for epigastric pains and incoercible vomits. Medical history revealed complex pathology as Kabuki syndrome and end-stage renal disease (the patient being into a peritoneal dialysis program). Laboratory data showed very low glomerular filtration rate, moderate chronic anemia, severe azotemia, metabolic acidosis, hyperkalemia, hyperphosphatemia, and hypocalcemia. An informed consent was obtained from his parents. Endoscopy found a normally appearance of antral mucosa and a giant mucosal fold located next to the pylorus with a double-headed polyp (the heads were approximately 1–1.5 cm in size), one head on the gastric part of the fold and the other protruding intermittently into the duodenum (Figure 3).

View Article: PubMed Central - PubMed

ABSTRACT

Isolated polyps of the upper digestive tract are rarely diagnosed in children, being usually an incidental finding during endoscopic exploration.

The diagnostic, therapy, and outcome of these lesions are based on endoscopy and pathology.

In a 5-year period, clinical features, topography, size, pathology, therapeutics, and progression of esophagogastric polyps founded in children addressed to our pediatric gastroenterology unit were studied.

The authors encountered 3 lesions in teenagers aged 13 to 17 years two males (2M), from a total number of 2140 upper digestive endoscopies (0.14%). All patients presented with pirosis, epigastric pain, and vomits; one of the children had end-stage renal disease and Kabuki syndrome. Endoscopic and pathologic findings were 2 esophageal polyps, an inflammatory one, and another containing goblet cells and a double-headed hyperplastic gastric polyp. Two patients received proton pump inhibitors without any improvement in subsequent endoscopic evaluations.

The difficulties related to age group, underlying conditions, debatable response to acid suppression, and limited experience in pediatric therapeutic endoscopy selected significantly the effectiveness of treatment.

The rarity of these lesions requires an individualized management, the endoscopic diagnostic, and therapeutic gesture depending on the symptoms, type, location, comorbidities, and team experience.

No MeSH data available.


Related in: MedlinePlus