Rectal polyp most commonly presents as
|D||Changes into malignancy|
a. In contrast to adenomatous polyps, hamartomatous polyps (juvenile polyps) are not usually premalignant.
b. These lesions are the characteristic polyps of childhood but may occur at any age.
c. Bleeding is a common symptom and intussusception and/or obstruction may occur.
d. Because the gross appearance of these polyps is identical to adenomatous polyps, these lesions should also be treated by polypectomy.
e. Familial juvenile polyposis is an autosomal dominant disorder in which patients develop hundreds of polyps in the colon and rectum.
f. Unlike solitary juvenile polyps, these lesions may degenerate into adenomas, and eventually carcinoma.
g. Annual screening should begin between the ages of 10 and 12 years.
h. Treatment is surgical and depends in part upon the degree of rectal involvement.
i. If the rectum is relatively spared, a total abdominal colectomy with ileorectal anastomosis may be performed with subsequent close surveillance of the retained rectum.
j. If the rectum is carpeted with polyps, total proctocolectomy is the more appropriate operation.
k. These patients are candidates for ileal pouch–anal reconstruction to avoid a permanent stoma.