COLONOSCOPY IN CHILDREN WITH RECTAL BLEEDING
Praveen Kumar*, A.K.Patwari**, VK Anand***, Akshay Kapoor****, R. Gondal*****
Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Lady Hardinge Medical College & Kalawati Saran Children's Hospital and *Department of Pathology, G.B. Pant Hospital, New Delhi *, Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Lady Hardinge Medical College & Kalawati Saran Children's Hospital and *Department of Pathology, G.B. Pant Hospital, New Delhi **, Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Lady Hardinge Medical College & Kalawati Saran Children's Hospital and *Department of Pathology, G.B. Pant Hospital, New Delhi ***, Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Lady Hardinge Medical College & Kalawati Saran Children's Hospital and *Department of Pathology, G.B. Pant Hospital, New Delhi ****, Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Lady Hardinge Medical College & Kalawati Saran Children's Hospital and *Department of Pathology, G.B. Pant Hospital, New Delhi *****
Introduction: Rectal bleeding is a common clinical problem which requires an appropriate diagnostic and therapeutic approach. Role of colonoscopy in the evaluation of rectal bleeding has been studied extensively in adults but not in younger population. Here we are presenting our experience of colonoscopy in children with rectal bleeding.

Objective: To study the diagnostic yield of colonoscopy in children with rectal bleeding and to analyze etiological diagnosis in our population.

Material & Methods: All children subjected to colonoscopy for rectal bleeding during September 2001 to July 2005 were retrospectively analyzed for their colonoscopic and histopathological findings.

Results: One hundred and eighty nine consecutive patients (3 m- 14 years) who underwent colonoscopy for rectal bleeding were studied. 5 children were of less than 1 year, 79 were between 1-5 children 5-10 years and 17 more than 10 years. Rectal polyps were detected in 118 (63%) of cases while in 71 patients no polyp was found. 91 patients were detected in 118 (63%) of cases while in 71 patients no polyp was found. 91 patients had single polyp while 27 patients had multiple polyps (maximum 9). In all patients, except 3 polypectomy was successfully done in the same sitting while 3 children needed repeat colonoscopy for polypectomy. Out of 71 patients in which no polyp was detected colonoscopic biopsy showed non-specific colitis in 38 patients, acute inflammatory colitis in 6 patients, 8 patients inflammatory bowel disease, 1 pseudomembranous colitis while no abnormality could be detected in 16 patients. No major complication related to colonoscopy was observed.

Discussion & Conclusions: Colonoscopy provides both rapid diagnosis and opportunity for therapeutic polypectomy. Rectal polyp was found to be most common cause of bleeding seen in 63% of cases. Our observations show that diagnostic yield of colonoscopy is very high in children presenting with rectal bleeding.
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