Abstract
Objective
To determine causes and management of rectal bleeding in infants and children.
Patients and Methods
This descriptive retrospective study was carried out at department of pediatric surgery, the children’s hospital, Pakistan Institute of Medical Sciences (PIMS), Islamabad from January 2010 to December 2010. All children under the age of 12 years presenting with rectal bleeding were included. The data was reviewed for age, gender, clinical characteristics and management. In all cases complete blood counts (CBC) was done, and patients with palpable rectal polyp underwent sigmoidoscopy. The rectal polyp and mucosal biopsy were sent for histopathology.

Results
Two hundreds eighty seven children were included in the study with a mean age of 5.25 years and male to female ratio of 2.3: 1. Out of 287 patients, 192(66.9%) were male and 95 (33.1%) were female. Rectal polyps were found the most common cause of bleeding (n-173, 60.3%). The polyp was mostly single pedunculated cherry red in color. Site of polyp was mostly the recto sigmoid or descending colon. Thirty six (12.5%) children were treated conservatively with the suspicion of infectious colitis. Intussusception (n=25), anal fissure (n=24), Meckel’s diverticulum (n=5), rectal prolapsed (n=16), Midgut volvulus with malrotation (n=4), juvenile polyposis coli (n=2) and necrotizing enter colitis (n=2) were other causes of rectal bleeding.
Conclusion
Juvenile colorectal polyps were the most common cause of rectal bleeding in children. Most were removed by colonoscopic polypectomy. Majority of the polyps were hyperplastic or hamartomatous. (Rawal Med J 2011;36:281-283).

Key words: Rectal polyp, rectal bleeding, digital rectal examination.