“Four cases of rectal polyposis occurring in one family” by Arthur F. Hertz, M.D., published by the British Journal of Children Diseases in 1914.

The parents of the patients are both alive and healthy and nothing abnormal was found in either of them on rectal examination. It is interesting to note, however, that in the first report of K. W__, when she was in the Hospital in 1906, it was said that the father was supposed to have a growth of the rectum. On being questioned recently with regard to this he did not know to what it referred, as he had no recollection of having suffered from intestinal symptoms.

There are four children. The eldest, H. W__, is aged 17 years. He is in the Navy, and I have not had an opportunity of seeing him. When aged 11 months, however, he suffered severely from hemorrhage of the bowels, which continued for several months, and was so severe at one time that he nearly died. Since the age of 3 years there has been no return of hemorrhage, His history is of importance only when taken in association with that of the other three members of the family, as it then appears probable that he also has a rectal polypus.

W.W__, aged 13 years, had pain on defecation and passed a little blood on two occasions in 1910. From that time he had frequent diarrhea with occasional vomiting after meals. His Mother brought him to see me in November, 1913, and said that she thought that he had a rectal polypus, as his symptoms were like those of his younger brother and sister, who had already been operated upon. He had, however, passed neither blood nor mucus, and there did not seem to be much evidence in favor of this posterior wall about one inch from the anal orifice. This was removed a few days later, and the patient has since remained well.

K. W__, is now aged 12 years. She was admitted into Guy’s Hospital in September, 1906, for vomiting, constipation, and the passage of blood, which had first been noticed a fortnight before. She was rapidly relieved, but in November of the same year she was re-admitted with abdominal pain and pyrexia. It was thought she might be suffering from tuberculous peritonitis. She very slowly improved and left the Hospital three months later quite well. I first saw her in January, 1910, when she was brought to see me because of passing blood. I could not make a satisfactory rectal examination then, as her rectum was full of feces. After an enema had been given with a good result, a proctoscope showed a small polypus on the posterior wall of the rectum about two inches from the anal canal, which was also quite easily felt by the finger. It was removed, and the patient remained well until 1912, when she returned with constipation and a history of having again passed a little blood.

The sigmoidoscope now showed nothing abnormal except slight catarrhal proctitis, which was clearly due to dyschezia, as an X-ray examination showed that the rectum was reached in nine and a half hours, and that the feces then remained indefinitely in the rectum. By means of graduated enemata the dyschezia was cured.

J. W__, aged 8 years, passed some blood and mucus in January, 1913. He had occasional pain on defecation with a tendency to diarrhea. I saw him at the end of September, 1913, and found a small polypus on the posterior rectal wall one inch from the anal orifice. He has remained well since it was removed a few days later.

I have not been able to find any record of a similar group of cases of rectal polypi occurring in one family.