Isolated duodenal adenoma presenting as gastrointestinal bleed - a case report

Abstract

Duodenal polyps are rare lesions in patients undergoing Esophago-gastro-duodenoscopy (EGD), and the prevalence varies widely with range of 0.3-4.6% of cases. Duodenal adenomas most commonly occur in association with familial adenomatous polyposis. Isolated occurrence of such adenomas is very rare and presentation as upper gastrointestinal (GI) haemorrhage is even rarer. We herein report a case of elderly male patient presenting to emergency department with features of upper GI bleeding. Patient was resuscitated followed by EGD was done. On EGD bleeding duodenal polyp was found and endoscopic polypectomy was done to control the bleeding. Subsequent colonoscopy was done and was normal. The histopathological examination of the polypectomy specimen revealed tubular adenomatous polyp which is a premalignant condition. We also highlight the clinical presentation, histological types and treatment modalities available in the literature. However, there is lack of consensus regarding the outcome of various procedure described in the literature.

Keywords: Endoscopic polypectomy; Isolated duodenal polyp; Upper gastrointestinal bleed.

[Table/Fig-1]:

EGD showing sessile polyp in first part of duodenum

[Table/Fig-2]:

Microscopy (Tubular structures lined by dysplastic cells x100 HE)