CASE REPORT
A long way to a simple diagnosis – a case report of an overlooked juvenile polyp
 
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Department of Pediatrics, Medical University, Warszawa, Poland 2Department of Pediatric Pulmonology, Medical University, Łódź, Poland
 
 
Submission date: 2025-01-15
 
 
Final revision date: 2025-03-03
 
 
Acceptance date: 2025-03-06
 
 
Publication date: 2025-06-06
 
 
Corresponding author
Andrea Horvath
Andrea Horvath, MD, Department of Pediatrics, Medical University, Warszawa, Poland
 
 
Pediatr Pol 2025;61(2):195-198
 
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ABSTRACT
Lower gastrointestinal bleeding (also known as rectal bleeding) is a common symptom reported to a pediatrician. It can be caused by a variety of medical conditions across different age groups, including in the majority, benign and common, such as annal fissure, rectal polyps or gastrointestinal infection. We report the case of a 10-year-old boy with an isolated juvenile polyp. The multi-symptoms and inappropriate/incorrect initial diagnosis (eosinophilic colitis) led to unnecessary medical tests and interventions, including a highly restrictive diet. This case highlights the need for higher awareness of the most common causes of rectal bleeding which should be firstly excluded. It also shows a challenging diagnosis in case of several gastrointestinal symptoms that may be associated with more than one possible disorder. Highly restrictive elimination diet in children is related to some risks and should be used only in conditions with some evidence of its efficacy.
REFERENCES (15)
1.
Osman D, Djibré M, da Silva D, et al. Management by the intensivist of gastrointestinal bleeding in adults and children. Ann Intensive Care 2012; 2: 1-17.
 
2.
Romano C, Oliva S, Martellossi S, et al. Pediatric gastrointestinal bleeding: perspectives from the Italian Society of Pediatric Gastroenterology. World J Gastroenterol 2017; 23: 1328-1337.
 
3.
Gagnier JJ, Kienle G, Altman DG, et al. The CARE guidelines: consensus-based clinical case reporting guideline development. Forschende Komplementarmedizin 2013; 20: 385-386.
 
4.
Alfadda AA, Storr MA, Shaffer EA. Eosinophilic colitis: epidemiology, clinical features, and current management. Therap Adv Gastroenterol 2011; 4: 301-309.
 
5.
Mennini M, Fiocchi AG, Cafarotti A, et al. Food protein-induced allergic proctocolitis in infants: Literature review and proposal of a management protocol. World Allergy Organ J 2020; 13: 100471.
 
6.
Paramo-Zunzunegui J, Ortega-Fernandez I, Benito-Barbero S, et al. Eosinophilic colitis: an infrequent disease with difficult diagnose. BMJ Case Rep 2020; 13: 6-8.
 
7.
Lwin T, Melton SD, Genta RM. Eosinophilic gastritis: histopathological characterization and quantification of the normal gastric eosinophil content. Mod Pathol 2011; 24: 556-563.
 
8.
Chernetsova E, Sullivan K, de Nanassy J, et al. Histologic analysis of eosinophils and mast cells of the gastrointestinal tract in healthy Canadian children. Hum Pathol 2016; 54: 55-63.
 
9.
Koutri E, Papadopoulou A. Eosinophilic gastrointestinal diseases in childhood. Ann Nutr Metab 2019; 73: 18-28.
 
10.
Rached AA, Hajj WE. Eosinophilic gastroenteritis: approach to diagnosis and management. World J Gastrointest Pharmacol Ther 2016; 7: 513.
 
11.
Zbuk KM, Eng C. Hamartomatous polyposis syndromes. Nat Clin Pract Gastroenterol Hepatol 2007; 4: 492-502.
 
12.
Ibrahimi N, Septer SS, Lee BR, et al. Polyp characteristics of nonsyndromic and potentially syndromic juvenile polyps: a retrospective cohort analysis. J Pediatr Gastroenterol Nutr 2019; 69: 668-672.
 
13.
Shah S, Youssef E, Saccio M, et al. Juvenile polyp. J Emerg Med 2011; 41: e111-e112.
 
14.
Pamudurthy V, Lodhia N, Konda VJA. Advances in endoscopy for colorectal polyp detection and classification. Bayl Univ Med Cent 2020; 33: 28-35.
 
15.
Zeevenhooven J, Koppen IJN, Benninga MA. The new Rome IV criteria for functional gastrointestinal disorders in infants and toddlers. Pediatr Gastroenterol Hepatol Nutr 2017; 20: 1-13.
 
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