Endoscopic resection of a juvenile jejunum polyp which caused recurrent intestinal bleeding in a 12-month-old child: clinical observation

BACKGROUND: To verify a source of obscure gastrointestinal bleeding leading to iron deficiency anemia is a challenging diagnostic problem. Intestinal polyps can be one of such sources. Sporadic juvenile intestinal polyps are extremely rare at the first year of life. The authors present a clinical case which demonstrates endoscopic diagnostics and resection of a jejunum polyp in a 12-month-old child weighing 6.3 kg. We did not find similar publications in literature. CLINICAL CASE DESCRIPTION: A 12-month-old boy was admitted to our clinic with long-lasting complaints of dark stool and iron deficiency anemia. For the first time, gastrointestinal bleeding symptoms appeared at the age of one month. The child was repeatedly examined, but gastrointestinal bleeding source was not found. The child was prescribed symptomatic therapy for iron deficiency anemia including red blood cell transfusion. At current hospitalization in our clinic an intestinal polyp and transient small intestinal intussusception were suspected at ultrasound examination. The child underwent esophagogastroduodenoscopy, video capsule endoscopy, colonoscopy, laparoscopy. But the source of the bleeding was not found. During the repeated enteroscopy at 40 cm distally to the pylorus a sporadic juvenile jejunum polyp 17×15 mm was found and resected. The postoperative period was uneventful. In 1 month, there were no complaints as for the catamnesis, the child's stool had the usual characteristics, the indicators of "red blood" corresponded to the age norm. CONCLUSION: A sporadic juvenile jejunal polyp may be a cause of obscure recurrent intestinal bleeding in children. Modern intraluminal endoscopy allows not only to put diagnosis, but also to perform a minimally invasive surgical intervention.