Pólipos intestinales en pacientes de 0-15 años en el Departamento de Gastroenterología en el Hospital Francisco Icaza Bustamante durante el período enero 2012 –diciembre 2014
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2015
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
Los pólipos son pequeños tumores benignos que aparecen en la mucosa del colon y del recto. Suelen ser bastante frecuentes en la población de más de 50 años.
Cuando se observa un pólipo al microscopio, se aprecia que existen varios tipos diferentes: Hiperplásicos- Inflamatorios- Adenomatosos:
Los pólipos aparecen en aproximadamente 1% en los niños en edad pre- escolar y escolar. Representan la causa más frecuente de sangrado rectal. Lo más frecuente es que se localicen en el colon y den sangrado rectal. La mayoría de los pólipos son los llamados Pólipos Inflamatorios (80%). Los pólipos con características adenomatoideas y potencialmente malignos se ven en menos del 3% de los casos. Ocasionalmente, los pólipos que aparecen en niños pueden pertenecer a un desorden de poliposis gastrointestinal genético caracterizado por: presencia de múltiples pólipos a lo largo del tracto gastrointestinal, histopatología, historia familiar de poliposis, y un aumento del riesgo de cáncer en el tracto gastrointestinal y de otros órganos.
Los pólipos juveniles del intestino grueso son comunes durante la infancia, usualmente se presentan con sangrado rectal sin dolor. Estas lesiones, conocidas como pólipos juveniles, son benignas y no tienen predisposición a malignizarse; Sin embargo, la verdadera incidencia de pólipos en la infancia es desconocida. La mayoría de pólipos juveniles son diagnosticados en la primera década de vida. Los pólipos son raros durante el primer año de vida y menos comunes en niños mayores de 10 años de edad. El pico de incidencia ocurre entre 2 y 6 años de vida. Hay evidencia de diferentes estudios realizados acerca de pólipos juveniles en los que se observa un predominio del sexo masculino en la patología.
Hasta un 20 % de los pacientes con pólipos juveniles, generalmente únicos, pueden tener otras anomalías congénitas, como lesiones cardiacas, mal rotación intestinal, divertículo de Meckel y alteraciones en el tamaño y forma de la cabeza. La examinación ano-rectal puede detectar en muchos casos la presencia de pólipos de localización baja, por lo general firmes, móviles, como masas pedunculadas.
Los procedimientos endoscópicos como la rectoscopia y la colonoscopia son los de elección para el diagnóstico de pólipos colorectales de todos los tamaños, a la vez que permite la resección de la mayoría de los pólipos
Palabras Claves: Pólipos- Sangrado rectal- genético-juveniles
Polyps are small benign tumors that occur in the lining of the colon and rectum. Usually quite common in the population over 50 years. When a polyp is observed microscopically, it is appreciated that there are several different types: Adenomatous Inflamatorios- Hiperplásicos-: Polyps occur in approximately 1% in children of school and preschool age. They represent the most frequent cause of rectal bleeding. Most often they are located in the colon and rectal bleeding den. Most polyps are called inflammatory polyps (80%). The adenomatoid polyps and malignant characteristics are potentially less than 3% of cases. Occasionally, polyps appear in children belong to a genetic disorder characterized by gastrointestinal polyposis: presence of multiple polyps throughout the gastrointestinal tract, histopathology, family history of polyps, and an increased risk of cancer in the gastrointestinal tract and other organs. Juvenile polyps of the large intestine are common during childhood, usually present with painless rectal bleeding. These lesions, known as juvenile polyps are benign and have no predisposition to malignant; However, the true incidence of polyps in children is unknown. Most juvenile polyps are diagnosed in the first decade of life. Polyps are rare in the first year of life and less common in children over 10 years old. The peak incidence occurs between 2 and 6 years. There is evidence from different studies conducted on juvenile polyps in which a predominance of males in the pathology observed. Up to 20% of patients, usually only juvenile polyps, may have other congenital abnormalities such as heart damage, intestinal malrotation, Meckel and alterations in the size and shape of the head. Anorectal examination can detect the presence in many cases of low location of polyps, generally firm, mobile, as pedunculated masses. Endoscopic procedures as rectoscopy and colonoscopy are the choice for the diagnosis of colorectal polyps of all sizes, while allowing resection of polyps most Keywords: bleeding rectally Polipos- genetic-youth
Polyps are small benign tumors that occur in the lining of the colon and rectum. Usually quite common in the population over 50 years. When a polyp is observed microscopically, it is appreciated that there are several different types: Adenomatous Inflamatorios- Hiperplásicos-: Polyps occur in approximately 1% in children of school and preschool age. They represent the most frequent cause of rectal bleeding. Most often they are located in the colon and rectal bleeding den. Most polyps are called inflammatory polyps (80%). The adenomatoid polyps and malignant characteristics are potentially less than 3% of cases. Occasionally, polyps appear in children belong to a genetic disorder characterized by gastrointestinal polyposis: presence of multiple polyps throughout the gastrointestinal tract, histopathology, family history of polyps, and an increased risk of cancer in the gastrointestinal tract and other organs. Juvenile polyps of the large intestine are common during childhood, usually present with painless rectal bleeding. These lesions, known as juvenile polyps are benign and have no predisposition to malignant; However, the true incidence of polyps in children is unknown. Most juvenile polyps are diagnosed in the first decade of life. Polyps are rare in the first year of life and less common in children over 10 years old. The peak incidence occurs between 2 and 6 years. There is evidence from different studies conducted on juvenile polyps in which a predominance of males in the pathology observed. Up to 20% of patients, usually only juvenile polyps, may have other congenital abnormalities such as heart damage, intestinal malrotation, Meckel and alterations in the size and shape of the head. Anorectal examination can detect the presence in many cases of low location of polyps, generally firm, mobile, as pedunculated masses. Endoscopic procedures as rectoscopy and colonoscopy are the choice for the diagnosis of colorectal polyps of all sizes, while allowing resection of polyps most Keywords: bleeding rectally Polipos- genetic-youth
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POLIPOS INTESTINALES, HEMORRAGIA, PEDATRIA, HOSPITAL DEL NIÑO FRANCISCO DE ICAZA BUSTAMANTE, CANTON GUAYAQUIL, ECUADOR