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Polypes et polyposes recto-coliques de l’enfant

Polyps and recto-colic polyposis of the child

  • Published:
Acta Endoscopica

Résumé

En pédiatrie, la coloscopie trouve une de ses plus fréquentes indications dans l’exploration des rectorragies dont les polypes constituent l’étiologie la plus commune [18].

Le terme de polype a une signification uniquement morphologique. Il désigne toute formation bien circonscrite sessile ou pédiculée qui fait saillie dans la lumière intestinale. Cet aspect macroscopique correspond à des lésions histologiques variées, les unes fréquentes, les autres exceptionnelles. Ainsi, distingue-t-on des polypes d’origine non épithéliale (lymphoïdes, léiomyomateux, lipomateux, neurofibromateux) et des polypes d’origine épithéliale (inflammatoires, hyperplasiques, hamartomateux, adénomateux ou néoplasiques). A chaque type de polype peut correspondre une polypose de même type. Mais la définition de la polypose demeure controversée. Morson exige la présence de plus de 1 000 polypes [18]. Potet [24] appelle polypose «toute collection de plus de huit polypes qui ont tendance à se reproduire et à augmenter en nombre à deux examens successifs». Lyogueet coll. [16] réservent ce terme à «un ensemble de syndrômes dans lesquels existent de nombreux polypes sur un segment de grêle, du côlon ou des deux».

Summary

In pediatrics, one of the most frequent indications of colonoscopy is the exploration of rectal bleeding of which polyps form the most common etiology [18].

The term polyp has a purely morphological meaning. It refers to any well defined sessile or pedunculated growth, bulging in the intestinal lumen. This macroscopic appearance corresponds to various histological lesions, some of which are frequent, others, exceptional. Thus, we can distinguish polyps of non epithelial origin (lymphoid, leiomyomatous, lipomatous, neurofibromatous) and polyps of epithelial origin (inflammatory, hyperplastic, hamartomatous, adenomatous or neoplastic). For each type of polyps, there is a corresponding polyposis of the same type. But the definition of polyposis remains controversial. Morson demands the presence of more than 1 000 polyps [18]. Potet [24] calls polyposis «any collection of more than 8 polyps which have a tendancy to reproduce and increase in number over two successive examinations». Lyogueet al. [16] use this term for «a group of syndromes in which numerous polyps exist on a segment of the small intestine, the colon or both».

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Authors and Affiliations

  1. Centre Inter-Hospitalier d’Endoscopie Digestive et Proctologie Pédiatrique, Hôpital Robert Debré et Hôpital Necker-Enfants Malades, Paris, France

    J. -F. Mougenot, A. Munck, T. Saleh & Y. Vannerom

  2. Laboratoires d’anatomie-pathologie, Hôpital Robert Debré et Hôpital Necker-Enfants Malades, Paris, France

    N. Brousse & M. Peuchmaur

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  1. J. -F. Mougenot
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Mougenot, J.F., Brousse, N., Munck, A. et al. Polypes et polyposes recto-coliques de l’enfant. Acta Endosc 24, 449–459 (1994). https://doi.org/10.1007/BF02968666

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