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duodenal-adenoma duodenal-adenoma duodenal-adenoma duodenal-adenoma
1 2 3 4 › 4

2 Endoscopy
D Duodenum
duodenal polyp, intramucosal adenocarcinoma, endoscopic resection

Authors: BIANCANIELLO Francesca, D’OVIDIO Valeria, Roma, Italy

A 57-year-old woman was admitted to the Emergency Department with cough and fatigue. Blood tests revealed severe iron deficiency anemia, requiring blood transfusion. Therefore, she underwent upper GI endoscopy which revealed a large, peduncolated  duodenal polyp with a reddish caput and an adenomatous pit pattern, originating from the superior duodenal flexure. Both major and minor papilla were identified. The patient underwent cap-assisted EMR (C-EMR) under deep sedation. After placing a clip on the base of the polyp stalk and injecting epinephrine (1:20000), the polyp was resected en bloc and retrieved using a Roth net. Two additional clips were placed to prevent delayed bleeding. Histological examination showed a high-grade adenoma with areas of intramucosal carcinoma (pTis) and assessed an R0 resection.

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