Polyps of the Colon beyond the Reach of the Sigmoidoscope.

cases from the H6pital de Baviere de Liege (Belgium) have been added, making in all 15 out of a total of 400 cases of recto-colonic polyps. Are remote polyps in children much less common than recto-sigmoidal polyps? In the adult, this disproportion is only apparent, systematic necropsies showing clearly that the localization of adenomas in the different segments of the large intestine (rectum included) is fairly regular (Chapman, 1963; Feyrter, 1931) (Fig. la). The studies on adults show that the frequency increases with age, with 20% in the third and the fourth decades, 31 % in the fifth, 61 % in the sixth, and more than 75% after 80 years. Children's polyps are quite different. Helwig (1946) found that amongst 449 necropsies of children and young adults under 21 years of age, there were only 5 subjects suffering from polyps: 1 polyp of the rectum in a 4-year-old boy; 8 polyps ofthe rectum in an 8-year-old boy; 1 polyp of the rectum in a 12-year-old girl; 1 polyp of the ascending colon in a 7-year-old girl; and 1 polyp of the caecum in a 1 5-year-old girl. In all, there were 10 polyps of the rectum, I of the ascending colon, and I of the caecum (Fig. I b). The incidence must be higher in small children on account of the extreme scarcity of these polyps in adolescents. It is well known that they are quite exceptional before the age of 1 year; their frequency increases very quickly after 2 years, to reach a maximum between 4 and 5 years (Duhamel, 1958). After this age, polyps become