Unusual Presentation of Gastric Polyp in a Young Child: A Ca
Gastrointestinal polyps are described as abnormal lesions that originate in the gastric epithelium or sub mucosa and protrude into the stomach lumen. It may present as an isolated lesion, or could be multiple as part of juvenile polyposis. It could be hereditary or acquired; hamartomatous or hyperplastic in structure; sessile or pedunculated in shape and of benign or malignant origin. Rectal lesions are the commonest in children but gastric polyps are rarely described in this age group, especially in those less than five years old [1]. Clinical presentation of gastric polyps in children varies widely, from incidental endoscopic finding to massive gastrointestinal bleeding [1]. We report a case of unusual upper gastrointestinal bleeding causing severe anaemia requiring blood transfusion secondary to gastric polyp in a young child.

Case Report
A 5-year old otherwise healthy girl presented to the local hospital with a short history of lethargy and pallor. There was no history of vomiting or diarrhoea initially but after 2 days she developed melaena. Clinically she was found to be pale and tachycardic initially with a systolic heart murmur, which resolved after transfusion. There was no evidence of hepato-splenomegaly, lymphadenopathy or jaundice. She was born at full term and had no history of hospital admission. Her initial investigations showed a slightly raised CRP of 38 mg/l and low Haemoglobin of 4.6 grams/dl; which warranted an urgent blood transfusion. Otherwise her renal function, coagulation screen and liver functions were all within normal limits. Abdominal ultrasound scan findings were normal. A meckle’s radioisotope scans showed no evidence of Meckle’s diverticulitis. After stabilization she was referred for an urgent gastroscopy, which revealed an intragastric mass extending across the pylorus (Figure 1).....