Most common cause of fresh bleeding per rectum in a 5 years old child is
(D) (Juvenile rectal polyp)* Fresh bleeding indicates bleeding from anal canal or rectum.* Whenever a child comes with bleeding per anum, a diagnosis of rectal polyp should be made until it is excludes by rectal examination.* According to C.P.P.T. common causes of bright red bleeding in a children 2-12 year old in decreasing order frequency are-- Anal fissure- Solitary rectal ulcer- Juvenile polyp- Lymphonodular hyperplasia.Differential diagnosis of bright red bleeding from rectum InfantChild (2-12 yrs)Adolescent >12Hematochezia with diarrhea and crampy abdominal painInfectious colitisPseudomembranous colitisEosinophilic coliisHirschsprung's entrocolitisInfectious colitis pseudomembranous colitisHemolytic uremic syndromeH.S. purpuraLymphonodular hyperplasiaInfectious colitisPseudomembranouscolitisGranulomatous colitisH.U.SH.S.P.Hematochezia without diarrhoea and abdominal painAnal fissure Eosinophilic colitis Rectal gastric mucosa, heterotropiaColonic hemangiomasAnal fissureSolitary rectal ulcerJuvenile polypLymphonodular hyperplasiaAnal fissure HemorrhoidSolitary rectal ulcerColonic A-V malformationThe aetiology and man and management of rectal bleeding depends on the age of the child, the type and quantity of bleeding and the associated symptoms. Unlike adults malignancy is exceptionally rare. In infants an anal fissure, necrotizing enterocolitis, intussusceptions and allergic enterocolitis are possible causes. In older children, more common causes includes an anal fissure, a juvenile polyp and certain gastroenteritides (e.g. Campylobacter infection); Meckel's diverticulum, duplication cyst and inflammatory bowel disease are less common. - Bailey and Love.Juvenile polyps are the most common type of childhood polyp, occurring in up to 1% of preschool children. The solitary polyps found in the rectum which most commonly present with rectal bleeding.These are hamartomatous polyps, which are usually pedunculated but can be sessile. The typical child with a juvenile polyp is 4 to 6 years of age, presents with intermittent painless rectal bleeding with bowel movements. - Rudolph's PediatricsJuvenile polyps are usually are not premalignant. Because the gross appearance of these polyps is identical to adenomatous polyps, these lesions should also be treated by polypectomy.Juvenile polyposis is a term used when more 5 to 10 juvenile polyps develop.Juvenile polyposis coli applies if the polyps are limited to the colon, whereas generalzed juvenile polyposis describes the presence of polyps throughout the GI tract, both have a significant malignant potential.Mentioned options are rare in childrenFamilial adenomatous polyposis (FAP) patients present in 2nd to 3rd decade.Rectal ulcer (solitary rectal ulcer) is commonly seen in 20 to 40 yrs age group.Piles are rare in children. (Ref: Rudolp'spediatrics, 21/e chapter 17.22)* MC solid tumor in childhood- Brain tumors* MC extracranial solid tumor in childhood - Neuroblastoma* MC intraabdominal solid tumor in childhood - NeuroblastomaCauses of Recurrent Gross Haematuria (2169-Nelson '8th)1. IgA Nephropathy - (MC cause)2. Alport's syndrome3. Thin glomerular basement membrane disease4. Hypercalciuria5. Urolithiasis* MCC of vasculitis in children is Henoch- schonlein prupura (HSP)* MC tumors in children are Leukaemia* MC solid tumors in children are CNS tumors* MC site of brain tumors in children is Infratentorial (cerebellar)* MC site of brain tumors in neonates is supratentorialMC posterior fossa tumour in children is cerebellar Astrocytoma* The Leukemias (ALL) are the most common malignant neoplasms in childhood
Volvulus
Trauma
Worm infestation
Juvenile rectal polyp
Gastro Intestinal System