Uncommon cause of hematochezia in older adults: a solitary juvenile polyp in the transverse colon

老年人便血的罕见病因:横结肠孤立性幼年性息肉

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Abstract

OBJECTIVE: To report a rare case of a solitary juvenile polyp in the transverse colon causing hematochezia in an older patient. PATIENTS AND METHODS: A 78-year-old woman presented with hematochezia. She denied experiencing abdominal pain and had no history of colonoscopy. Colonoscopy performed at a local hospital revealed a 12 mm pedunculated lesion in the transverse colon covered with fresh blood. The patient was then referred for further evaluation. After confirming the cessation of bleeding, the lesion was removed via endoscopic mucosal resection. Histopathological analysis was performed on the resected specimen. RESULTS: The lesion was successfully resected without complications. Histological examination revealed the typical features of juvenile polyps, including stromal expansion, edema, inflammatory cell infiltration, and crypt dilation without cytological atypia. The surgical margins were negative. The patient remained asymptomatic after the procedure and experienced no recurrence of bleeding. CONCLUSION: Juvenile polyps are typically found in children but can occasionally occur in older patients. This case underscores the importance of considering juvenile polyps in the differential diagnosis of lower gastrointestinal bleeding, regardless of patient age. Complete endoscopic and histopathological evaluation is essential for accurate diagnosis and appropriate management.

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