P2283 - Juvenile Polyp Presenting as Hematochezia in an Elderly Patient

Dipen Patel, MD, MBA¹, Justin Chuang, MD¹, Jordan Burlen, MD¹, Christian Nehme, MD¹, Sami Ghazaleh, MD², Azizullah Beran, MD², Cameron Burmeister, MD, MS², Waleed Khokher, MD¹, Syed Hasan, DO^1
1University of Toledo, Toledo, OH; ²University of Toledo Medical Center, Toledo, OH

Introduction: Juvenile polyps are commonly found in pediatric patients but may occur in patients of any age. While usually asymptomatic, they can present as a source of GI bleeding. They may present as either solitary polyps or part of juvenile polyposis syndrome. In this case, we present an 89-year-old female patient who presented with hematochezia from a large 4.5 cm juvenile polyp in her sigmoid colon.

Case Description/Methods: An 89-year-old female with a past medical history of chronic lymphocytic leukemia, diverticulosis, type two diabetes mellitus, essential hypertension, and multifactorial anemia was admitted to the hospital with hematochezia. Patient had a hemoglobin of 6.9 g/dl on presentation. At home, she was not on any anticoagulation or antiplatelet agents. She was transfused a unit of blood. CT abdomen and pelvis with contrast showed sigmoid diverticulosis. Colonoscopy was performed during that admission which showed hemorrhoids on perianal exam, one 6 mm polyp in the sigmoid colon, one 3 mm polyp in the transverse colon, diverticulosis in the sigmoid colon, and a 4.5 cm Juvenile polyp in the sigmoid colon. Polyps were removed and sent for pathological examination. Patient’s 4.5 cm juvenile polyp was found to be ulcerated and was likely the source of patient’s hematochezia. After colonoscopy and polypectomy, patient’s hematochezia resolved, and she was discharged home Patient was scheduled to have a repeat colonoscopy in a few months after this encounter.

Discussion: Juvenile polyps are usually in the sphere of practice of pediatric gastroenterologists. However, they may be seen in patients with any age. While found in 2% of pediatric patients, they are rare in adult populations. Juvenile polyps causing symptoms in adults is seen much less frequently. Juvenile polyps are usually not associated with malignancy.



Disclosures:


Dipen Patel, MD, MBA¹, Justin Chuang, MD¹, Jordan Burlen, MD¹, Christian Nehme, MD¹, Sami Ghazaleh, MD², Azizullah Beran, MD², Cameron Burmeister, MD, MS², Waleed Khokher, MD¹, Syed Hasan, DO¹. P2283 - Juvenile Polyp Presenting as Hematochezia in an Elderly Patient, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.