Intestinal polyps in children

Intestinal polyps may occur in a variety of people. If an adult suffers from intestinal polyps, he or she will know how to take care of and regulate himself or herself. However, if a child suffers from intestinal polyps, it is difficult to treat and will make the child feel particularly painful. However, the probability of children having polyps is still relatively high because the gastrointestinal development of children is not particularly complete. So what should children do if they suffer from intestinal polyps?

1. Common classifications of colon polyps are as follows:

1. Juvenile polyps: About 90% occur in children under 10 years old, more commonly in boys. The appearance is round or oval, with a smooth surface. 90% grow within 25 cm from the anus, most are less than 1 cm in diameter, the vast majority have pedicles, and about 25% are multiple. Histologically, they appear as well-differentiated glands of irregular size, some of which form cystic dilations, store mucus, have interstitial hyperplasia, and have more inflammatory cell infiltration, and sometimes ulcers form on the surface. Secondary polyps generally do not become malignant.

2. Hyperplastic polyps: Hyperplastic polyps are the most common type of polyps, also known as metaplastic polyps. Most of them are distributed in the distal large intestine and are generally small, with a diameter rarely exceeding 1 cm. They appear as a small drop-shaped protrusion on the mucosal surface with a smooth surface and a wide base. Multiple polyps are also common. Histologically, this type of polyp is formed by enlarged and regular glands. The increase in glandular epithelial cells causes the skin to shrink and present a serrated shape. The cell nuclei are regularly arranged, and their size and chromatin content change very little. Nuclear division phases are rare. Its important feature is that mature cells appear in the middle and lower sections of the intestinal gland crypts. Hyperplastic polyps do not become malignant.

3. Inflammatory polyps: Inflammatory polyps, also known as pseudopolyps, are polyp-like granulomas caused by long-term chronic inflammation of the intestinal mucosa. This type of polyp is often seen in the diseased intestines of ulcerative colitis, chronic schistosomiasis, amoebic dysentery, intestinal tuberculosis and other diseases. They are often multiple, mostly small, with a diameter of less than 1 cm. They may increase in size with a long course of illness. The appearance is mostly narrow, long, with a wide pedicle and irregular distal end. Sometimes it is bridge-shaped, with both ends attached to the mucosa and the middle part free. The histological manifestations are fibrous granulation tissue, and the epithelial components may also show mesenchymal changes, but it is still uncertain.

4. Adenoma: Colon adenoma is a benign epithelial tumor of the large intestine. According to the histological structure, it is divided into three types: tubular adenoma, villous adenoma and mixed adenoma.

(1) Tubular adenoma: It is a round or oval polyp with a smooth or lobed surface. It varies in size, but most of them are less than 1 cm in diameter. 80% have pedicles. Histologically, the glands are mostly tubular, with immature cells distributed at all levels of the glands. There may be varying degrees of mesenchymal changes and sometimes a small amount of papillary hyperplasia. The canceration rate is around 1% to 5%.

(2) Villous adenoma: less common than tubular adenoma, most of which are solitary. They are generally large in size, with diameters mostly over 1 cm. Most are broad-based, and about 10-20% may have pedicles. The surface is dark red, rough or has villous protrusions or small nodules, is soft and fragile, and is movable when touched. If a hard lump or fixation is touched, it indicates the possibility of cancer. The most common distribution area is the rectum, followed by the sigmoid colon. The histological manifestation is that the epithelium grows in a papillary manner, with a vascular connective tissue stroma in the center, which also proliferates along with the epithelium and is divided into papillary growth. The epithelial cells show obvious anaplasia. Its canceration rate is more than 10 times that of tubular adenoma.

(3) Mixed adenoma: an adenoma that has both of the above structures. Its canceration rate is between tubular adenoma and villous adenoma.

5. Familial colon polyps: Familial colon polyps with blood in the stool belong to adenomatous polyposis syndrome, an autosomal dominant hereditary disease, occasionally seen in people with no family history. Multiple adenomas can occur in the entire colon and rectum. Most adenomas have peduncles, while papillary adenomas are less common. The number of polyps ranges from about 100 to several thousand, ranging from the size of soybeans to several centimeters in diameter. They are often densely arranged, sometimes in clusters, and their tissue structure is no different from that of general adenomas.

It can reach more than 3000 ml per day, leading to severe dehydration, electrolyte imbalance, circulatory failure, acidosis and other metabolic disorders. If supplemental treatment is not given promptly and the adenoma is not managed, it can be life-threatening.

6. Familial polyposis is a rare hereditary polyposis. The colon and rectum are full of polyp-like adenomas, and it is only a matter of time before they become malignant. Moreover, the malignant transformation is often not limited to one place but is multi-centric. In fact, some patients already have colorectal cancer when they seek medical treatment.