DrVirgo
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38. A mother brings her 4 year old son the the ER because of bright red blood in the toilet after his last BM. This was the first time she had seen blood in the toilet bowl, but she had occasionally noted very small amounts of bloo d on the toilet paper ove rthe past several months. On examination, his temperature is 37.6 C (99.6 F), pulse is 90/min, RR: 22/min. The abdomen is soft, nontender, and non distended, and bowel sounds are normal. Examination fo the perineal region reveals a 3 cm round beefy red mass protruding from the child's anus. The mass appears friable and is easily pushed back through the anal sphincter. Which of the following is the most likely diagnosis?
A. Anal fissure
B. Colonic adenocarcinoma
C. Hirschsprung disease
D. Juvenile colonic polyp
E. Meckel diverticulum
Explain the answer and WHY you chose it... Thanks. 
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| Ivil
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D. juvenile polyp.. mc in first decade.. presents as PR bleeding or mass protuding PR.
A.. painful..not associated with a 3cm mass.. if atall ther could be a skin tag which is not friable..
B. not common in this age gr...
C.. no PR bleeding
E.. no PR mass
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| yasmeen
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POLYP
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| DrVirgo
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Correct Answer: D
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| r_albayunen
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D 
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