Enter your Email address:
Wolters Kluwer Health may email you for journal alerts and information, but is committed
to maintaining your privacy and will not share your personal information without
You currently have no recent searches
Fitzgerald, Joseph F.; Troncone, Riccardo; Sood, Manu; Murphy, M. Stephen
Department of Paediatric Gastroenterology and Nutrition, Institute of Child Health, Birmingham, United Kingdom
A 12-year-old girl complained of bloody diarrhoea 10 days after returning to the United Kingdom from a vacation in Bulgaria. She passed up to 20 bloody, mucoid stools daily associated with marked tenesmus. Physical examination, including digital rectal examination, was normal. Stool microbiological studies were negative. Colonoscopy showed mild mucosal erythema in the distal rectum. However, retroflexion of the colonoscope revealed a pale, mucosal polyp approximately 1 cm diameter at the anorectal junction (Fig. 1). Rectal mucosal biopsies showed mild nonspecific inflammation. The polyp was surgically excised and submitted for histologic examination.
A. What was the diagnosis?
B. What is the pathophysiology of this disorder?
Answer: An inflammatory cloacogenic polyp (ICP).
Histology showed areas of surface erosion and disorganization of the muscularis mucosa with upward extension through the lamina propria--a feature characteristic of this condition (Fig. 2).
This child had "mucosal prolapse syndrome," which leads to mucosal injury, probably as a consequence of ischemia. In this syndrome, either ICPs or solitary rectal ulcer may result. Similar histologic abnormalities are seen in these two related entities. These patients often suffer from tenesmus and may engage in repetitive nonproductive straining. They pass small quantities of blood and mucus. ICPs are a well-recognized cause of rectal bleeding and tenesmus in adults, but have only recently been described in children (1,2). They are soft, friable polyps and therefore may be missed on digital rectal examination. They can be overlooked at colonoscopy because of their distal location. Performing a retroflexion manoeuvre of the colonoscope may help to visualise the anorectal junction.
© 1998 Lippincott Williams & Wilkins, Inc.
Colleague's E-mail is Invalid
Your Name: (optional)
Separate multiple e-mails with a (;).
Thought you might appreciate this item(s) I saw at Journal of Pediatric Gastroenterology and Nutrition.
Send a copy to your email
Your message has been successfully sent to your colleague.
Some error has occurred while processing your request. Please try after some time.
An Existing Folder
A New Folder
The item(s) has been successfully added to "".
Login with your LWW Journals username and password.
Username or Email:
Enter and submit the email address you registered with. An email with instructions to reset your password will be sent to that address.
Link to reset your password has been sent to specified email address.
What does "Remember me" mean?
By checking this box, you'll stay logged in until you logout. You'll get easier access to your articles, collections,
media, and all your other content, even if you close your browser or shut down your
To protect your most sensitive data and activities (like changing your password),
we'll ask you to re-enter your password when you access these services.
What if I'm on a computer that I share with others?
If you're using a public computer or you share this computer with others, we recommend
that you uncheck the "Remember me" box.
Save my selection
Article Level Metrics