【Case 1】A previous healthy, 4-year-old boy was referred to our hospital because of acute onset of rectal bleeding with an evacuated polyp. Digital examination showed a fresh bleeding without any polyps. The bleeding from the stalk of the autoamputated polyp was suspected. Emergency colonoscopy under general anesthesia revealed an oozing stalk at the rectum. Clipping and spraying ALTO® was performed endoscopically. There were no other polyps in the proximal colon. Pathological findings showed a juvenile polyp.
【Case 2】A 2-year-old girl, who had an episode of autoamputation of a polyp 6 months ago, was referred to our hospital because of a polyp in the stool. She was suspected to have the multiple polyps, and total colonoscopy was performed. No other polyps were detected in the colon. Pathological findings also showed a juvenile polyp.
【Conclusion】A colonoscopy was needed to stop bleeding from the stalk of the autoamputated polyp at case 1, and to see the total colon whether the polyp was multiple or not at case 1 and 2. Juvenile polyp has been reported to have a malignant potential. We believe that total colonoscopy should be the initial procedure when evaluating a child with suspected juvenile polyp.
