Juvenile polyps are a type of polyp found in the colon. While juvenile polyps are typically found in children, they may be found in people of any age. Juvenile polyps are a type of hamartomatous polyps, which consist of a disorganized mass of tissue. They occur in about two percent of children. Juvenile polyps often do not cause symptoms (asymptomatic); when present, symptoms usually include

gastrointestinal bleeding Gastrointestinal bleeding (GI bleed), also called gastrointestinal hemorrhage (GIB), is all forms of bleeding in the gastrointestinal tract, from the mouth to the rectum. When there is significant blood loss over a short time, symptoms may incl ...

and prolapse through the rectum. Removal of the polyp (

polypectomy In medicine, a polypectomy is the removal of an abnormal growth of tissue called a polyp. Polypectomy can be performed by excision if the polyp is external (on the skin). See also * Colonic polypectomy * Non-lifting sign The non-lifting sign i ...

) is warranted when symptoms are present, for treatment and definite histopathological diagnosis. In the absence of symptoms, removal is not necessary. Recurrence of polyps following removal is relatively common. Juvenile polyps are usually sporadic, occurring in isolation, although they may occur as a part of

juvenile polyposis syndrome Juvenile polyposis syndrome is an autosomal dominant genetic condition characterized by the appearance of multiple juvenile polyps in the gastrointestinal tract. Polyps are abnormal growths arising from a mucous membrane. These usually begin appe ...

. Sporadic juvenile polyps may occur in any part of the colon, but are usually found in the distal colon (

rectum The rectum is the final straight portion of the large intestine in humans and some other mammals, and the Gastrointestinal tract, gut in others. The adult human rectum is about long, and begins at the rectosigmoid junction (the end of the s ...

and

sigmoid Sigmoid means resembling the lower-case Greek letter sigma (uppercase Σ, lowercase σ, lowercase in word-final position ς) or the Latin letter S. Specific uses include: * Sigmoid function, a mathematical function * Sigmoid colon, part of the l ...

). In contrast to other types of colon polyps, juvenile polyps are not premalignant and are not usually associated with a higher risk of cancer; however, individuals with juvenile polyposis syndrome are at increased risk of

gastric The stomach is a muscular, hollow organ in the gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach i ...

and

colorectal cancer Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the colon or rectum (parts of the large intestine). Signs and symptoms may include blood in the stool, a change in bowel m ...

., Unlike juvenile polyposis syndrome, solitary juvenile polyps do not require follow up with surveillance colonoscopy.

Signs and symptoms

Juvenile polyps often do not cause symptoms (asymptomatic); when present, symptoms usually include gastrointestinal bleeding and prolapse through the rectum. Juvenile polyps are usually sporadic, occurring in isolation, although they may occur as a part of

. Sporadic juvenile polyps may occur in any part of the colon, but are usually found in the distal colon (

and

Histopathology

Under microscopy, juvenile polyps are characterized by cystic architecture, mucus-filled glands, and prominent lamina propria. Inflammatory cells may be present. Compared with sporadic polyps, polyps that occur in juvenile polyposis syndrome tend to have more of a frond-like (resembling a leaf) growth pattern with fewer stroma, fewer dilated glands and smaller glands with more proliferation. Syndrome-related juvenile polyps also demonstrate more

neoplasia A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

and increased

COX-2 Prostaglandin-endoperoxide synthase 2 (prostaglandin G/H synthase and cyclooxygenase) (The HUGO official symbol is PTGS2; HGNC ID, HGNC:9605), also known as cyclooxygenase-2 or COX-2, is an enzyme that in humans is encoded by the ''PTGS2'' gene ...

expression compared with sporadic juvenile polyps.

Diagnosis

Juvenile polyps are diagnosed by examination of their distinctive histopathology, generally after polypectomy via endoscopy. Juvenile polyps cause

fecal calprotectin Faecal calprotectin (American and British English spelling differences#ae and oe, or fecal calprotectin) is a stool test, biochemical measurement of the protein calprotectin in the human feces, stool. Elevated faecal calprotectin indicates the mig ...

level to be elevated.

Treatment

If symptoms are present, then removal of the polyp (polypectomy) is warranted. Recurrence of polyps following removal is relatively common. Unlike juvenile polyposis syndrome, solitary juvenile polyps do not require follow up with surveillance colonoscopy.

Epidemiology

Juvenile polyps occur in about 2 percent of children. In contrast to other types of colon polyps, juvenile polyps are not premalignant and are not usually associated with a higher risk of cancer; however, individuals with juvenile polyposis syndrome are at increased risk of

and

References

{{Digestive system neoplasia Digestive system neoplasia Histopathology