Hamartomous Polyp of the Rectum vs. Adenomatous Polyp of the Colon
Left picture: Due to the age and mainly due to the histology it is a juvenile (hamartomous) polyp of the rectum which is prolapsing to the anal opening. Permanent cure is achieved if no additional polyps of the same type are present. Right picture: According to the histological examination an adenomatous polyp was present here which occurs in children less frequently than hamartomous polyps. In case of familial occurence of more than 3 polyps and of a histology as in the case report and/or of a clinical presentation diverging from that of a juvenile polyp or of extraintestinal findings, a familial polyposis has to be considered; among them, a special type of the adenomatous polyposis of the colon regularly exhibits a malignant degeneration if no preventive measures are taken. In the picture at the bottom of the corresponding side, a segment of an enema is visible with double contrast in a nearly 5-year-old boy with numerous polyps in the region of the left colonic flexure, demonstrated by contrast deposits.
Left picture: Gaping anus in a 5-year-old girl with mucus and blood in the panties. A large prolapsing mass is visible. Right picture: Operative preparation of a nearly 13-year-old girl with passage of blood by the anus. The mass has a diameter of 1 cm and a length of 4 cm. It has been resected from the colon including a broad base of it.