ABSTRACT
Rectal bleeding in young children is most commonly caused by anal fissures (>90%), with the next most common cause from a juvenile polyp. The presenting symptoms of polyps are bright red rectal bleeding (90%), with abdominal pain (10%) and prolapse through the anal canal (4%) making up other presenting symptoms. The historic shift of juvenile polyps to the more proximal colon and the concern for the presence of juvenile polyposis (more than five juvenile polyps), with its increased risk of malignancy, mandates that the entire colon be surveyed. Polyps in the rectum can be removed easily during anoscopy. More proximal surveillance needs to be done by pancolonoscopy. After all polyps have been removed within the area of the anoscope or if no polyps are found in the most distant rectum, pancolonoscopy is performed. All polyps are removed endoscopically by the standard snare technique.
