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Ultrasonographic
diagnosis of juvenile colonic polyps.
J Pediatr. 1994 ;124(4):535-40.
To reduce the
risks of air-contrast barium enemas and colonoscopy, we studied the
use of saline enemas for ultrasonographic examination of children with
rectal bleeding. Thirty-nine children, from 2 years 8 months to 8
years 3 months of age, were examined. Juvenile colonic polyps were
ultrasonographically demonstrated and histologically confirmed in 25
children; all the polyps were solitary and pedunculated, and were
located in the splenic flexure in 3 children, the descending colon in
6, the sigmoid colon in 12, and the rectum in 4. Ultrasonographic
findings by hydrocolonic ultrasonography were identical to those
obtained by immersion ultrasonography of removed specimens. Hypoechoic
areas within more hyperechoic polyps were shown histologically to be
dilated glandular canals. The 14 children in whom no abnormal
ultrasonographic findings were shown had no further rectal bleeding
after resuming regular defecation, and 5 of these 14 had negative
colonoscopic findings. No adverse reactions were noted in any child
during or after the saline enema examination. We conclude that
ultrasonographic examination with a saline enema is a safe and
accurate method of assessing children with rectal bleeding, especially
for the diagnosis of juvenile colonic polyps.
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