• Tidak ada hasil yang ditemukan

Colonic Polyposis: Experience in Seven Filipino Adolescents

N/A
N/A
Protected

Academic year: 2023

Membagikan "Colonic Polyposis: Experience in Seven Filipino Adolescents"

Copied!
5
0
0

Teks penuh

(1)

ȏȏȏȏȏȏȏȏȏȏȏȏȏȏȏȏȱ ȱ

ȱ

˜››Žœ™˜—’—ȱŠž‘˜›DZȱ Ž›–Š—Šȱǯȱ ›Ž˜›’˜ǰȱǰȱ‘ȱ

ޙЛ–Ž—ȱ˜ȱŽ’Š›’Œœȱȱ

‘’•’™™’—Žȱ ޗޛЕȱ˜œ™’Š•ȱȱ

—’ŸŽ›œ’¢ȱ˜ȱ‘Žȱ‘’•’™™’—ŽœȱŠ—’•Šȱȱ

ŠȱŸŽ—žŽǰȱ›–’ŠǰȱŠ—’•Šǰȱ‘’•’™™’—ŽœȱŗŖŖŖȱ

ޕޙ‘˜—ŽDZȱƸŜřŘȱśŘŜşŗŜŝȱ

–Š’•DZȱŽ›–Š—Šŗȓ‘˜–Š’•ǯŒ˜–ȱ ȱ

ȱ

˜•˜—’Œȱ˜•¢™˜œ’œDZȱ¡™Ž›’Ž—ŒŽȱ’—ȱŽŸŽ—ȱ’•’™’—˜ȱ˜•ŽœŒŽ—œȱ ȱ

ž¢ȱ¢—ȱǯȱ’žȱŠ—ȱ Ž›–Š—Šȱǯȱ ›Ž˜›’˜ȱ

ȱ

ŽŒ’˜—ȱ˜ȱŽ’Š›’Œȱ Šœ›˜Ž—Ž›˜•˜¢ǰȱŽ™Š˜•˜¢ȱŠ—ȱž›’’˜—ǰȱޙЛ–Ž—ȱ˜ȱŽ’Š›’Œœǰȱ˜••ސŽȱ˜ȱŽ’Œ’—ŽȱŠ—ȱ‘’•’™™’—Žȱ ޗޛЕȱ˜œ™’Š•ǰȱ

—’ŸŽ›œ’¢ȱ˜ȱ‘Žȱ‘’•’™™’—ŽœȱŠ—’•Šȱ

ȱ ȱ Abstract

We report seven adolescents presenting with hematochezia.

Five had a family history of colonic polyps or cancer.

Colonoscopy showed either multiple pedunculated and/or sessile polyps with partial or total colonic involvement. Polyp histopathology was of the juvenile retention, hamartomatous or tubular adenomatous type. Total proctocolectomy was done in four patients, two underwent repeated polypectomy, and one is awaiting further treatment. An increased awareness of colonic polyposis is important due to the risk of malignant transformation.

Key Words: hematochezia, colorectal carcinoma, prolapsed rectal mass

ȱ

—›˜žŒ’˜—ȱ

˜•˜—’Œȱ™˜•¢™œȱŠ›Žȱ›˜œœ•¢ȱŸ’œ’‹•Žȱ™›˜›žœ’˜—œȱ›˜–ȱ‘Žȱ

–žŒ˜œŠ•ȱœž›ŠŒŽȱ˜ȱ‘Žȱ•Š›Žȱ’—Žœ’—ŽȱŠ—ȱŒ˜––˜—•¢ȱ™›ŽœŽ—ȱ  ’‘ȱ ›ŽŒŠ•ȱ ‹•ŽŽ’—ǰȱ Š‹˜–’—Š•ȱ ™Š’—ǰȱ ’Š››‘ŽŠȱ Š—ȱ ›ŽŒŠ•ȱ

™›˜•Š™œŽǯȱ —ȱ Œ‘’•›Ž—ǰȱ şŚƖȱ ˜ȱ Œ˜•˜—’Œȱ ™˜•¢™œȱ Š›Žȱ ’œ˜•ŠŽȱ

“žŸŽ—’•Žȱ ™˜•¢™œǯŗǰŘȱ ˜ ŽŸŽ›ǰȱ œ˜–Žȱ ™Š’Ž—œȱ –Š¢ȱ ‘ŠŸŽȱ –˜›Žȱ

‘Š—ȱ ’ŸŽȱ ǻ–ž•’™•ŽǼȱ ™˜•¢™œȱ  ‘’Œ‘ȱ Š›Žȱ –˜œ•¢ȱ •˜ŒŠŽȱ ’—ȱ

™›˜¡’–Š•ȱ ™Š›ȱ ˜ȱ ‘Žȱ Œ˜•˜—ǰŘȱ Šȱ Œ˜—’’˜—ȱ ŒŠ••Žȱ Œ˜•˜—’Œȱ

™˜•¢™˜œ’œȱ ˜›ȱ™˜•¢™˜œ’œȱ Œ˜•’ǯřȱ ‘Žȱ ›žŽȱ ’—Œ’Ž—ŒŽȱ ˜ȱ ™˜•¢™œȱ ’—ȱ

Œ‘’•‘˜˜ȱ ›Ž–Š’—œȱ ž—”—˜ —ǰȱ Š—ȱ ’—ȱ Š••ȱ œž’Žœǰȱ Šȱ –Š•Žȱ

™›Ž™˜—Ž›Š—ŒŽȱ’œȱ—˜ŽǯŚǰśȱ••ȱŽ‘—’Œȱ›˜ž™œȱŒŠ—ȱ‹ŽȱŠŽŒŽǯŜȱ

ŠœŽœȱ˜ȱŒ˜•˜—’Œȱ™˜•¢™˜œ’œȱŠ›ŽȱŒ•Šœœ’’Žȱ‘’œ˜•˜’ŒŠ••¢ȱŠœȱ

—Ž˜™•Šœ’Œȱ ǻ‹Ž—’—ȱ ˜›ȱ –Š•’—Š—Ǽȱ ˜›ȱ —˜—Ȭ—Ž˜™•Šœ’Œȱ ǻ’—•Š––Š˜›¢ȱ ˜›ȱ ‘Š–Š›˜–Š˜žœǼǯȱ ‘Ž›Žȱ Š›Žȱ ‘›ŽŽȱ –Š’—ȱ

™˜•¢™˜œ’œȱœ¢—›˜–Žœȱ‘Šȱœ‘Š›Žȱ‘ŽȱŽŠž›Žœȱ˜ȱŠ—ȱŠž˜œ˜–Š•ȱ

˜–’—Š—ȱ –˜Žȱ ˜ȱ ’—‘Ž›’Š—ŒŽȱ Š—ȱ Š—ȱ ’—Œ›ŽŠœŽȱ ›’œ”ȱ ˜ȱ

Œ˜•˜›ŽŒŠ•ȱ ŒŠ—ŒŽ›DZȱ “žŸŽ—’•Žȱ ™˜•¢™˜œ’œȱ ǻǼǰȱ Š–’•’Š•ȱ

ŠŽ—˜–Š˜žœȱ ™˜•¢™˜œ’œȱ ǻǼǰȱ Š—ȱ Žž£Ȭސ‘Ž›œȱ™˜•¢™˜œ’œȱ ǻǼǯŝȱ ’œ˜•˜’ŒŠ••¢ǰȱ Š—ȱ ŠŽ—˜–Š˜žœȱ ™˜•¢™ȱ ‘Šœȱ

™›˜•’Ž›Š’—ȱ Ž™’‘Ž•’Š•ȱ ž‹ž•Žœȱ  ’‘ȱ ’–’—ž’˜—ȱ ’—ȱ ‘Žȱ

—ž–‹Ž›ȱ ˜ȱ ˜‹•Žȱ ŒŽ••œǰȱ Œ›˜ ’—ȱ ˜ȱ —žŒ•Ž’ȱ Š—ȱ ’—Œ›ŽŠœŽȱ ’—ȱ

‘Žȱ —ž–‹Ž›ȱ ˜ȱ –’˜’Œȱ ’ž›ŽœȯŽŠž›Žœȱ Œ‘Š›ŠŒŽ›’œ’Œȱ ˜ȱ

—Ž˜™•Šœ–ǯȱ ȱ —ȱ ‘Žȱ ˜‘Ž›ȱ ‘Š—ǰȱ “žŸŽ—’•Žȱ ™˜•¢™œȱ Š›Žȱ

‘Š–Š›˜–Šœȱ ‘Šȱ ŽŸŽ•˜™ȱ ›˜–ȱ Š—ȱ Š‹—˜›–Š•ȱ Œ˜••ŽŒ’˜—ȱ ˜ȱ

’œœžŽȱ ޕޖޗœȱ ‘Šȱ Š›Žȱ ˜‘Ž› ’œŽȱ —˜›–Š••¢ȱ ™›ŽœŽ—ȱ Šȱ ‘’œȱ

œ’Žǯȱ‘Ž¢ȱ‘ŠŸŽȱŠȱ’œ’—Œ’ŸŽȱŒ¢œ’ŒȱŠ›Œ‘’ŽŒž›Žǰȱ–žŒžœȬ’••Žȱ

•Š—œǰȱ ™›˜–’—Ž—ȱ •Š–’—Šȱ ™›˜™›’Šȱ Š—ȱ Šȱ ™›˜•’Ž›Š’˜—ȱ ˜ȱ

’—•Š––Š˜›¢ȱ ŒŽ••œǯȱ ‘ŽœŽȱ ŽŠž›Žœȱ •ŽŠȱ ˜ȱ ˜ŸŽ›•Š™™’—ȱ

Ž›–’—˜•˜¢ǰȱ ’—Œ•ž’—ȱ ›ŽŽ—’˜—ǰȱ ‘¢™Ž›™•Šœ’Œȱ Š—ȱ

’—•Š––Š˜›¢ȱ ™˜•¢™œǰȱ Ž™Ž—’—ȱ ˜—ȱ ‘Žȱ ˜–’—Š—ȱ

‘’œ˜•˜’ŒŠ•ȱ ’—’—œǯȱ žœŒ•Žȱ ’‹Ž›œȱ Š—ȱ ‘Žȱ ™›˜•’Ž›Š’ŸŽȱ

Œ‘Š›ŠŒŽ›’œ’Œœȱ˜ȱŠŽ—˜–ŠœȱŠ›Žȱ¢™’ŒŠ••¢ȱ—˜ȱœŽŽ—ȱ’—ȱ“žŸŽ—’•Žȱ

™˜•¢™œǯŜǰŞȱ

˜•˜—’Œȱ ™˜•¢™˜œ’œȱ ’—ȱ Œ‘’•‘˜˜ȱ ’œȱ Š—ȱ ž—Œ˜––˜—ȱ

Œ˜—’’˜—ȱ ’‘ȱŒŠœŽȱœŽ›’Žœȱ›Ž™˜›Žȱ›˜–ȱ—’ŠǰŚǰşȱ‘Š’•Š—ǰŗŖȱ

Š”’œŠ—ǰśȱ ЙЗǰŗŗȱ Š—ȱ ˜‘Ž›ȱ Œ˜ž—›’Žœȱ •’”Žȱ œ›ŠŽ•ǰŗŘȱ ǰŗřȱ

Š—ȱ’—•Š—ǯŝȱȱ™›ŽœŽ—ǰȱ‘Ž›ŽȱŠ›Žȱ—˜ȱ›Ž™˜›œȱ˜—ȱ‘Žȱ’œŽŠœŽȱ

’—ȱ ‘Žȱ ‘’•’™™’—Žœǯȱ —ȱ ‘Žȱ •Šœȱ ˜ȱ ¢ŽŠ›œǰȱ  Žȱ ‘ŠŸŽȱ œŽŽ—ȱ Š—ȱ

’А—˜œŽȱœŽŸŽ—ȱŠ˜•ŽœŒŽ—œȱ ’‘ȱŒ˜•˜—’Œȱ™˜•¢™˜œ’œǰȱŠ••ȱ ’‘ȱ

Š—ȱ ’—’’Š•ȱ ™›ŽœŽ—Š’˜—ȱ ˜ȱ ‘Ž–Š˜Œ‘Ž£’Šǰȱ ’Š››‘ŽŠȱ Š—ȱ

Š‹˜–’—Š•ȱ ™Š’—ǯȱ ‘Žȱ Œ˜•˜—’Œȱ ™˜•¢™œȱ  Ž›Žȱ ŽŽŒŽȱ ˜—ȱ

Œ˜•˜—˜œŒ˜™¢ȱ Š—ȱ Œ˜—’›–Žȱ ˜—ȱ ‘’œ˜™Š‘˜•˜¢ǯȱ Žȱ ™›ŽœŽ—ȱ

‘Ž’›ȱ Œ•’—’ŒŠ•ȱ ™›˜’•Žȱ Š—ȱ –ЗАޖޗǰȱ Š•˜—ȱ  ’‘ȱ Šȱ ›ŽŸ’Ž ȱ

˜ȱ•’Ž›Šž›Žȱ˜—ȱŒ˜•˜—’Œȱ™˜•¢™˜œ’œǯȱȱ

˜—œŽ—ȱ Šœȱ˜‹Š’—Žȱ›˜–ȱ‘ŽȱŠ–’•’Žœȱ˜ȱ‘Žȱ™Š’Ž—œȱ

˜›ȱ’—Œ•žœ’˜—ȱ’—ȱ‘’œȱŒŠœŽȱœŽ›’Žœǯȱȱœž––Š›¢ȱ˜ȱŠ••ȱ‘ŽȱŒŠœŽœȱ’œȱ

™›ŽœŽ—Žȱ’—ȱŠ‹•Žȱŗǯȱ ȱ

ŠœŽœȱŗȱŠ—ȱŘȱ

 ˜ȱœ’‹•’—œǰȱŽ–Š•ŽœȱŗŗȱŠ—ȱŗřȱ¢ŽŠ›œȱ˜ȱАŽǰȱŒ˜—œž•Žȱ

˜›ȱ œŽŸŽ›Žȱ Š‹˜–’—Š•ȱ ™Š’—ǰȱ ‘Ž–Š˜Œ‘Ž£’Šȱ Š—ȱ ™›˜•Š™œŽȱ

›ŽŒŠ•ȱ–Šœœǯȱ‘Ž’›ȱŠ‘Ž›ȱ‘Šȱœ’–’•Š›ȱœ¢–™˜–œȱŠ—ȱ’Žȱ˜ȱ

Šœ›’ŒȱŒŠ—ŒŽ›ȱŠȱřŚȱ¢ŽŠ›œȱ˜ȱАŽǯȱȱȱ

‘Žȱ ¢˜ž—Ž›ȱ œ’‹•’—ȱ  Šœȱ —˜Žȱ ˜ȱ ‘ŠŸŽȱ Šȱ ™›˜•Š™œŽȱ

›ŽŒŠ•ȱ–ŠœœȱŠȱŘȱ¢ŽŠ›œȱ˜•ǯȱȱȱŚȱ¢ŽŠ›œǰȱœ‘Žȱ‘Šȱ‘Ž–Š˜Œ‘Ž£’Šǯȱ

ȱ ‘Šȱ АŽǰȱ ™›˜Œ˜œ’–˜’˜œŒ˜™¢ȱ  Šœȱ ˜—Žȱ ˜ȱ ›Ž–˜ŸŽȱ Šȱ

•Š›Žȱ ™˜•¢™ȱ  ‘’Œ‘ȱ  Šœȱ ˜ž—ȱ ˜ȱ ‹Žȱ Šȱ “žŸŽ—’•Žȱ ›ŽŽ—’˜—ȱ

™˜•¢™ȱ ‹¢ȱ ‘’œ˜™Š‘˜•˜¢ǯȱ ™™Ž›ȱ Ž—˜œŒ˜™¢ȱ ›ŽŸŽŠ•Žȱ

–ž•’™•Žȱ Šœ›’Œȱ Š—ȱ ž˜Ž—Š•ȱ ™˜•¢™œǯȱ Ž–Š˜Œ‘Ž£’Šȱ

›ŽŒž››Žȱ Šȱ Şȱ ¢ŽŠ›œȱ ˜ȱ АŽȱ Š—ȱ АВ—ȱ Šȱ ŗŗȱ ¢ŽŠ›œǰȱ ‘Ž—ŒŽȱ ‘Žȱ

–˜œȱ ›ŽŒŽ—ȱ Œ˜—œž•ǯȱ —ȱ ™‘¢œ’ŒŠ•ȱ ޡЖ’—Š’˜—ǰȱ ‘Žȱ ™Š’Ž—ȱ  Šœȱ ™Š•Žǰȱ  ’‘ȱ –˜Ž›ŠŽȱ –Š•—ž›’’˜—ȱ ǻȱ ƽȬŘǼǯȱ ‘Žȱ ‘Šȱ

–ž•’™•Žȱœ”’—ȱ™’–Ž—Š’˜—œȱ–˜œȱ™›˜–’—Ž—ȱ˜—ȱ‘Žȱ•’™œȱŠ—ȱ

‹žŒŒŠ•ȱ–žŒ˜œŠȱǻ’ž›Žœȱŗȱ˜ȱŗǼȱŠ—ȱŠȱ™Š•™Š‹•Žȱ›ŽŒŠ•ȱ–Šœœǯȱ

ȱ ‘Žȱ ’–Žȱ ˜ȱ ‘’œȱ  ›’’—ǰȱ ‘Žȱ ™•Š—ȱ  Šœȱ ˜ȱ ˜ȱ Šȱ ˜Š•ȱ

Œ˜•˜—˜œŒ˜™¢ȱŠ—ȱ™˜œœ’‹•Žȱ™˜•¢™ŽŒ˜–¢ǯȱ

(2)

!0 1 * 1 1 1 $$ 0 < 0 @ 0E 1 8 55 55 8 55 ! 1

F <

>

8 1 1 1 6B2CDG)7@9 0 0 6; $7 1 1 $

@

! " #

$ $$ $( $* $' $' $3 $,

; ; ; ;

%&

''

+ ? $ ( )19 + 3

@9 @9

"0 0

0 @9

' ( &

&$

2 : 01

1

1

1

1

)($

&$&(

.

.

.

!0 !0

$

1 #8

! 1

! 1

! 1

! 1

)'$

*+,-+$./0

?( '+ ?) ,? ,* $() $%)

'

* ,!+$./0

($ $* )+ $* (?

'

*",!''./0

(3 ), (? )3 3*

1$ B

!

!C

B 1@2@

2@1@2@ B

2@1@2@

90

"0 !

@"H :

11:

0

($$

*2%0

H H H

I

(3)

<J 1 0

"1 1

"$': :1:

< 1 !1 0 $3 1 9 1 "

> 8 1 0 16B2CD%)7! 1 0 8 0 <

1 9 1

! %*$* <1 9?6;)" )B7 1 ! 1 0 5

! 1 0 0E E 0 06;)7 1 1 0

"$*: :1 < @ : 0 <1 0 KK 5 ! 1 >

8 1 6B2CDL:(7 0/0 0 9 8 1

! 1 5 6;("7

! 1 1 6; )7 0 6# 7

!

"$': : 1119 < 1 0 0 6; $7 @ 1 00 >

1 1 0 1 6B2CDLG(7

/0 8

0 9 @ 1 0 6;

(B7 @ 1 1 1 1 1 0

"

" $3: : 1 : 0:9 1:

1 0 1 101 1 1

"

0 1 1 > 8 6B2CD%

)7 0 1 90 ! 1 0

3 %

$ 8 1 6"70 6B7 67 67

(4)

1

" 1 !1

#

" $,: : 1 < 1 0 !1 1 01 0 ! 1 0 8 0 !1 > 8 1 9 0 0 "0

! : 1 1: 0 1 0 6;(7"1 1 0

%

A ; 1 1 <

1 8

! 6$) ,71 <G. @ 6.@7 +*4 1 $3

@ 1 < 1 0 >

0 ! 1 0 0 0 : 0 + ! 19:

: $*>

0

>

1 0 ; @"3 BF2" 3%'%4 15 $2 0 ,*4 1 5 1 1 $'$,!

3 %

$ 1 1 6"7 6B7 < %* $* 9 ? F 6M7

3

$ 1 . 6"7J 6B7 6

)

(5)

> 0 9 01 6"7 * 0 ( 3$$?!"

0 1 8 0 1

?$+ !" #$ ""%

9 1 01

<G. @ J?$3)% 8 $ ) 11

" 1 1 J 1 1 11 ! < 0 6N)%7 1 $)$ 2 0 9 0 A 1 1 5 1 5 0 9 $3$)$' A .@

9 01 0 8 ) ! 0 1 $3! .@1 1 ! 1 $ <$3 1.@(%4 *%49 0

?

! 1 2 0 0 1 5 0 0

$* 3$( 1.@ $32 0 1 2 1 0 3%$3 ! 33 $(

2 1 E ! 1 0 1 8 0 9

1&

$ " . )%%,J)$637)((G+

) " ! 5< ; 2 )%%+J$?6$7*(G'

( " 2 B . . . $+''J(6$7*G$'

3 "H @ @ . .2 "@)%%?J$(637$)?G($

* . 8 9 @ 2 )%%3J)%6*7((+G3) #0 )%%3

$?6"07

' . >1 @ 2 2 O F @ 2 > @ : @ BA9P

*)%%? B92 '(,G'*%

, . .

)%%(J*)6@227$+G))

? / . 1.F. @ 2 F"

B! F@ O F1Q2 R@

6A"7 A @J $++(G)%%( $( Q )%%?@%+R

+ ! BF O . "$++?J,?6(7)'3G'

$% 9 H@ 59. /9 H.

! :: A . @ )%%,J($6)7(+*G?6"07

$$ S ! H @ . "

. .@$+?)J$)637),3G+

$) F< B< ; 5 1 $+?)J3+6,7$*%%G(

$( B /" " /F9 5 )%%,J*'6,7+'*G,

$3 F <G.

@ . H)%%3J(+6)7)$+G)%

$* A B / H. 0 " ! "$+?)J*,6$73+G*(

$' " F B 0 O F @ )%%?J)$637)?%G*

$, # @ F)%%,J+6(7)(,G33

$? B " H ; 1 . H "

)%%$J+(6'7)%?G$(

$+ F @ 09 5 "

2@BH+*):+$:$,+):) >S 9)%%%

)% ; B . 0

" $++'J (+6'7?',G+

)$ 0A.21 @!9!!

H 2 .

$++$J'%6)7$+(G?

Referensi

Dokumen terkait

76 cases among a population of about 1.07 million, as of 5 August 2020.1 This is lower than the overall incidence of COVID-19 cases reported throughout Japan 0.034%, and lower than in