[Endoscopic piecemeal removal of large adenomatous duodenal polyp].

Duodenal polyps are rare pathologies. They can be single or multiple, like in familial adenomatous polyposis or Gardner syndrome. Histologically they are usually bening: adenomas, myomas, lipomas, carcinoids, Brunner adenomas or hamartomas. Malignant lesions are mainly adenocarcinomas localized in the ampulla of the Vater area. Small polyps localized in the superior or descending segment of duodenum can be usually removed endoscopically. Larger or more distally localized polyps must be excised surgically. The largest polyps, up to several centimeters, are adenomas. Ileus or anemia are the main symptoms. Here we report the case of a 52 year old woman with a large polyp (7 cm diameter) localized in the duodenal bulb presenting with anemia. The polyp was removed endoscopically with a piecemeal method using diathermic loop. Histopthologic examination revealed that it was a ademona with grade II dysplasia.