Juvenile Hamartomatous Polyp Causing Jejunal Intussusception in an Eight-Year-Old Child - A Case Report

Sep 28, 2026

Juvenile hamartomatous polyps are common in pediatrics but are almost always limited to the colon and rectum; small-bowel involvement is exceptionally rare and creates major diagnostic uncertainty. This case report presents an eight-year-old with vague constitutional symptoms, intermittent vomiting, abdominal pain, and marked weight loss (Z-score −3.29). Initial ultrasound, CT, upper endoscopy, and contrast studies failed to identify the cause. Exploratory laparotomy revealed a juvenile hamartomatous polyp in the mid-jejunum causing intermittent intussusception, confirmed after enterectomy, with complete symptomatic resolution.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages5

Reading Time13 min

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Abstract

Introduction

Case Presentation

Diagnostic Workup

Imaging and Findings

How to Cite This Article

Review began 12/16/2025 Review ended 12/28/2025 Published 12/31/2025 © Copyright 2025 Sugai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.100517 Open Access Case Report Juvenile Hamartomatous Polyp Causing Jejunal Intussusception in an Eight-Year-Old Child: A Case Report Gustavo Sugai Sr. 1, Eduardo Motta Buchaim 2, Tiago Mestriner Costa 2, Beatriz Gordilho Bacos 3 , Felipe Paglioli 2 1. Clinical Medicine, Irmandade de Misericórdia da Santa Casa de São Paulo, São Paulo, BRA 2. Internal Medicine, Irmandade de Misericórdia da Santa Casa de São Paulo, São Paulo, BRA 3. Internal Medicine, Universidade de Medicina Santo Amaro, São Paulo, BRA Corresponding author: Gustavo Sugai Sr., [gsugai27@gmail.com](gsugai27@gmail.com) Abstract While juvenile hamartomatous polyps are common pediatric findings, they are almost exclusively restricted to the colon and rectum; their occurrence in the small intestine is exceptionally rare and presents a significant diagnostic dilemma. This case report describes an eight-year-old patient who presented with vague constitutional symptoms, including intermittent vomiting, abdominal pain, and severe weight loss resulting in a Z-score of-3 .29. Initial diagnostic investigations, including abdominal ultrasound, computed tomography, upper digestive endoscopy, and contrast bowel studies, failed to identify a clear etiology. Following an exploratory laparotomy, a juvenile hamartomatous polyp was identified in the mid-jejunum, acting as a lead point for intermittent intussusception with secondary vascular congestion of the intestinal loops. The diagnosis was confirmed through anatomopathological analysis after a successful enterectomy. This case demonstrates that in the presence of unexplained malnutrition and cyclical emesis, clinicians must maintain a high index of suspicion for small bowel lesions, as prompt surgical intervention can prevent further complications and lead to complete symptomatic resolution. Categories: Pediatric Surgery, Pediatrics Keywords: chronic abdominal pain, colon cancer and colon polyps, gastrointestinal obstruction, hamartomatous polyp, polyps Introduction Juvenile hamartomatous polyps (JP) are the most frequent type of gastrointestinal polyp in the pediatric population, accounting for approximately 90% of cases. These lesions are almost exclusively found in the lower gastrointestinal tract, specifically in the colon and rectum. In contrast, the occurrence of a solitary juvenile polyp in the small intestine, particularly the jejunum, is exceptionally rare and significantly less documented, which complicates clinical and surgical management [1] . Gastrointestinal polyps are defined as epithelial or submucosal nodules that project into the intestinal lumen. While histological characteristics dictate their classification as benign or malignant, juvenile polyps are primarily characterized by an edematous lamina propria and dilated cystic glands [1] . Commonly, juvenile polyps present with intestinal bleeding and abdominal pain; however, these symptoms are often vague and overlap with other abdominal syndromes [2] . Standard diagnostic protocols typically involve endoscopy, barium enema, or colonoscopy, which serves as the gold standard for both diagnosis and removal, followed by anatomopathological examination [3] . However, unlike colonic lesions, jejunal polyps reside in a segment often inaccessible to standard upper digestive endoscopy and colonoscopy. In the case detailed herein, this anatomical location hindered the diagnostic process for a patient presenting with intermittent intestinal obstruction, vomiting, and severe malnutrition. Initial investigations-including abdominal ultrasound, computed tomography, u

FAQs

Why is the diagnosis difficult in this case of juvenile hamartomatous polyp?

Small-intestinal juvenile hamartomatous polyps are exceptionally rare, and the jejunal location is often inaccessible to standard endoscopy and colonoscopy. Initial imaging and endoscopic evaluations failed to reveal a clear cause.

What symptoms and clinical findings were present when the child was admitted?

The child had a five-month history of intermittent vomiting and abdominal pain with significant weight loss (5 kg). Severe malnutrition was evident with BMI 12 and a Z-score of −3.29, without palpable masses or peritonitis signs.

How was the final diagnosis confirmed and what treatment was performed?

Exploratory laparotomy identified a juvenile hamartomatous polyp in the mid-jejunum acting as a lead point for intermittent intussusception. Confirmation was achieved by anatomopathological analysis after successful enterectomy.

Sep 28, 2026

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