Faecal calprotectin and ultrasonography as non-invasive screening tools for detecting colorectal polyps in children with sporadic rectal bleeding: a prospective study

• Published in: Italian journal of pediatrics 2020-05, Vol.46 (1), p.66-66, Article 66
• Main Authors: Di Nardo, Giovanni, Esposito, Francesco, Ziparo, Chiara, Strisciuglio, Caterina, Vassallo, Francesca, Di Serafino, Marco, Villa, Maria Pia, Parisi, Pasquale, Evangelisti, Melania, Pacchiarotti, Claudia, Corleto, Vito Domenico
• Format: Article
• Language: English
• Subjects: Abdomen; Adolescent; Anemia; Anesthesia; Bleeding; Child; Child, Preschool; Children; Colon; Colonic Polyps - complications; Colonic Polyps - diagnosis; Colonic Polyps - metabolism; Colonoscopy; Colorectal polyps; Digital Rectal Examination; Endoscopy; Faecal calprotectin; Feces - chemistry; Female; Gastrointestinal Hemorrhage - diagnosis; Gastrointestinal Hemorrhage - etiology; Gastrointestinal Hemorrhage - metabolism; General anesthesia; Humans; Inflammation; Inflammatory bowel disease; Intestinal obstruction; Intestine; Leukocyte L1 Antigen Complex - metabolism; Male; Morphology; Neutrophils; Nonsteroidal anti-inflammatory drugs; Patients; Polyps; Prospective Studies; Rectum; Sensitivity and Specificity; Spleen; Ultrasonic imaging; Ultrasonography; Ultrasound; Variables
• ISSN: 1824-7288; 1720-8424; 1824-7288
• DOI: 10.1186/s13052-020-00828-1

Colorectal polyps are reported in 6,1% of paediatric colonoscopies and in 12% of those performed for lower gastrointestinal bleeding. Although colonoscopy is widely used in paediatric patients, it requires bowel preparation and general anaesthesia or deep sedation, and in rare cases, it can cause complications. Non-invasive screening techniques able to predict polyps in children with isolated and sporadic rectal bleeding may play a key role in the selection of patients needing colonoscopy. We enrolled all children undergoing colonoscopy for isolated and sporadic rectal bleeding to determine the diagnostic accuracy of faecal calprotectin, ultrasonography (US) and digital rectal examination as diagnostic methods for screening colorectal polyps. A total of 26 of 59 enrolled patients (44.1%) had colonic polyps, one patient had multiple polyps, and 23% of children had polyps proximal to the splenic flexure. The diagnostic accuracy of faecal calprotectin for detecting colorectal polyps was 96.6%, with a sensitivity of 100%. False-positive faecal calprotectin was shown in 2 patients with non-steroidal anti-inflammatory drug-related lesions. The diagnostic accuracy of ultrasound was 77.9%. Polyps not seen with ultrasound tended to be relatively smaller (1.5 vs 2.3, p = 0.001) and located in the rectum. The combined use of FC, US and digital rectal examination obtained a specificity and PPV of 100%. FC combined with US and digital rectal examination is a good and promising non-invasive screening test for detecting colorectal polyps in children with isolated and sporadic rectal bleeding.