关键词: 肠息肉； 肠套叠； 内镜； 儿童

Abstract: Objective To investigate the clinical features and risk factors of intestinal intussusception in children with intestinal polyps. Methods The clinical data of a number of 27 children with intestinal polyps undergone intussusception were retrospectively analyzed. Results Among the 27 cases, there were 17 males and 10 females, aged from 11 months to 16 years old, with an median age of five years. The median duration of disease was three days ( 4 hours to 13 years). The median hospital day was nine ( 5 ~ 14 ) days. Paroxysmal abdominal pain was the main symptom, followed by nausea and vomiting. All 27 cases were treated with air enema, and 17 cases were successful, including four cases of ileocolic intussusception and 13 cases of colo-colonic intussusception. 10 cases were treated by surgery after failed in air enema, including two cases of ileocolic intussusception, three cases of colo-colonic intussusception and five cases of small bowel intussusception. The proportion of colocolonic intussusception was higher in the successful group, while the proportion of small bowel intussusception was higher in the failed group, with statistical significance (P= 0 . 004 ). Colonic polyps were confirmed in 18 cases and small intestinal polyps in 7 cases by colonoscopy and surgery of 25 cases. Nine cases were Peutz-Jeghers Syndrome among them. Sixteen cases were pathologically diagnosed as juvenile polyps. The proportion of small polyps ( 1 . 5 ~ 2 . 5 cm) was higher in the juvenile polyp group, while the proportion of large polyps (≥4 . 0 cm) was higher in the Peutz-Jeghers Syndrome group, and the difference was statistically significant (P= 0 . 021 ). Binary logistic regression analysis showed that Peutz-Jeghers Syndrome was an independent risk factor for recurrence of intussusception (OR= 7 . 82 , 95 %CI: 1 . 16 - 52 . 69 , P= 0 . 035 ). Conclusions Intestinal polys greater than or equal to 1 . 5 cm are prone to intussusception. The risk of recurrence of intussusception can be increased by Peutz-Jeghers Syndrome. Colo-colonic intussusception was more likely to be successfully treated by air enema, but the polys should be removed by endoscopy as soon as possible.

Key words: intestinal polyps; intussusceptions; endoscopy; child