Non-familial juvenile polyposis

Video Endoscopic Sequence 1 of 4.

Non-familial juvenile polyposis

This is a 8 year-old male, who diagnosed in another clinic suffering from polyposis, the patient was referred to the National Children's Hospital of El Salvador. Where he had been scheduled for surgery to remove the entire colon.

We were referred for a second opinion where we have removed in nine therapeutic colonoscopies, 508 resected polyps, with loop diathermy and using argon plasma coagulator. But still it needs to be more extirpate polyps.

Significantly improved its corrected the anemia and bleeding.

Non-familial juvenile polyposis

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Non-familial juvenile polyposis

Video Endoscopic Sequence 2 of 4.

The differential diagnosis should include other syndromes associated with polyposis including Cowden syndrome and Bannayan-Riley-Ruvalcaba syndrome, familial adenomatous polyposis and Peutz-Jeghers syndrome.

Non-familial juvenile polyposis

Video Endoscopic Sequence 3 of 4.

Management should involve routine colonoscopy and if the number of polyps remains low endoscopic polypectomy is the gold standard for treatment. Due to the risk of cancer and polyposis extension, surgical colectomy associated with protectomy and ileoanal anastomosis may also be proposed.

The argon plasma coagulation was used for some tiny polyps.

Video Endoscopic Sequence 4 of 4.

The argon plasma coagulation was used for some tiny polyps.

 

 

 

Non-Familial Juvenile Polyposis, Polypectomy of Multiple Polyps, Second Colonoscopy

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 1 of 37.

Juvenile Non Familial Polyposis of the Colon.

This image and the video clip was taken at the age of two years and five months.

We have removed 172 juvenile polyps in nine different sessions from the age of 11 months to the 13 years Using the endoscopic polypectomy and the snare wire radio frequency electrical current.

No complications related to medication, colonoscopy, or snare polypectomy were observed.

Endoscopic snare polypectomy is an effective and safe treatment for colorectal polyps in the pediatric age group.

We used an adult colonoscope. Follow-up examinations, including total colonoscopy were performed in diferents edges.

 

 

 

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 2 of 37.

Colonic polyp, the most common gastrointestinal tumor in children, is considered a cause of rectal bleeding in the pediatric population. Colonoscopy is the gold standard procedure in diagnosis and therapeutic.

The image and the video displays two of the biggest polyps in the transverse colon at the age of tree year-old and seven months.

 

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 3 of 37.

Polypectomy of enormous polyps of the transverse colon.
At the age of tree years and seven months.

All polypectomies were carried out without using general anesthesia.

Juvenile polyps is the most common colonic polyps in children.

Colonoscopic polypectomy is effective in juvenile polyposis Surveillance colonoscopy is required in juvenile polyposis.

 

Juvenile Polyps of the Transverse Colon.

Video Endoscopic Sequence 4 of 37.

Juvenile Polyps of the Transverse Colon.

The largest polyps are at the transverse colon and can be appreciated in the image an the video clip.

The patient was born in 02/ 25/ 1992. The screen displays some information about his age.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 5 of 37.

At the aged of 3 years and 8 months, we removed several of the biggest polyps ( 27) in the transverse.

The video clip displays the colonoscopic polypectomy.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 6 of 37.

This image as well as the video clip is at the age of three years and eight months.

The ileocecal valve is seen, one of the hallmarks of the colonoscopy was complete. We have not found any polyps after the hepatic angle.

 

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 7 of 37.

One of the biggest polyps is seen at the splenic flexure, large and wide pedicle is observed.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 8 of 37.

The remanent stalk.

The coagulator is applied no longer than a few seconds.
The snare is gently tightened while the electrical current is applied.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 9 of 37.

One of the polyps, is being removed after snare resection.
The video clip displays the procedure.

Colorectal polyps are relatively frequent in infancy and constitute one of the main causes of bleeding per rectum.

Endoscopic polypectomy, with its lower morbidity and mortality, has revolutionized its treatment.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 10 of 37.

The video clip displays several polyps at the descending colon near of the splecnic flexure.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 11 of 37.

The cecum is observed at the aged of seven year-old.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 12 of 37.

Some polyps needed to be removed in fragments.

The two presenting symptoms, rectal bleeding and anemia, disappeared soon after polypectomy At the aged of 3 years and 8 months.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 13 of 37.

Removed polyps in one session at the edge of 3 years and 8 months.

Up to date we have removed 172 polyps in nine different days, from the age of 11 months to the thirteen years

The majority was removed between the ages of 3 years 7 months, 3 years 8 months and three years 9 months.

The penultimate time that they were extirpated 22 polyps in 1999, the last was in April 2005 with 64.

The traditional handling of multiple juvenile polyposis has generally been the surgery, he has had an excellent evolution.

 

 

 

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 14 of 37.

At the age of 13 years, 1 April 2005.

Our patient has evolved very well from the year rare occasions has had episodes of bleeding.

Three years previously, we were going to practice his colonoscopic control, after his bowel preparation the patient experienced fever of 40 degrees centigrade, that examination in that occasion was suspended.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 15 of 37.

The polyp is observed with magnifying colonoscope.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 16 of 37.

Multiple polyps of the rectum.

Most polyps are located in the rectum or the sigmoid colon.
No polyps were found at the right colon.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 17 of 37.

More images and video clips of multiple polyps of the rectum.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 18 of 37.

The cecum with the ileocecal valve.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 19 of 37.

Some parasites were found at the cecum.

It seem to be Trichuris Trichuris (whipworm).

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 20 of 37.

We performed endoscopic polypetomy of multiple polyps.

The polypectomies was carried out without using general anesthesia and is performed as an outpatient procedure.
We had no endoscopic complications.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 21 of 37.

A tiny and flat juvenile polyp is observed.

There were multiple polyps of several sizes, some of them could be considered as precursors or tiny flat polyps which are observed with a little if fibrin.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 22 of 37.

Chromoendoscopy using methylene blue.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 23 of 37.

Chromoendoscopy after methylene blue spray.

Involves the topical application of dyes to the mucosa.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 24 of 37.

White spots are arrangements of foamy cells at the periphery of a tumor. Most frequently found in association with cancers and large adenomas.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 25 of 37.

High Magnification.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 26 of 37.

Stalked Polyp of the Sigmoid Colon.

For methylene blue staining, the patient should be told that the urine and stool might adopt a blue color.

The enemy of good chromoendoscopy is surface mucus, blood, or retained food material.

The surface to be examined after application of dye should be washed. For the vital/absorptive dyes (e.g., Lugol’s iodine, methylene blue).

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 27 of 37.

An ulcerated polyps is observed, the lesion is encircled by numerous yellowish white spots.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 28 of 37.

The colonoscopic polypectomy.

In this session at the edge of 13 years, 64 polyps were removed between tiny and of medium size. No any polyp was left.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 29 of 37.

Colonoscopic snare polypectomy is a simple, effective, and safe procedure for treating colorectal polyps in children.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 30 of 37.

Cautery is applied to the wire loop which has been tightened around the stalk of the polyp.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 31 of 37.

The image and the video clip display some maneuver with the polypectomy snare.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 32 of 37.

The stalk of the polyp has been cut through.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 33 of 37.

The polyp outside the body.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 34 of 37.

Colonoscopic polypectomy was performed.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 35 of 37.

Diminutive Polyp.

Coagulation was used for small polyps as well as the argon plasma beam.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence 36 of 37.

Argon Plasma Beam (APC).

We used APC for some small polyps.

Juvenile Non Familial Polyposis of the Colon.

Video Endoscopic Sequence37 of 37

The argon plasma coagulation was used for some tiny polyps.

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