title: A case of lobulated and pedunculated duodenal hyperplastic polyp treated with snare polypectomy.
abstract: We report herein the case of a lobulated and pedunculated hyperplastic polyp in the third portion of the duodenum causing anemia and occult blood in stools, which was detected by capsule endoscopy (CE) and treated with snare polypectomy. A 71-year-old man was referred to our hospital because of anemia and occult blood in stools. Three months earlier, he had been admitted to another hospital because of hemorrhage from gastric antral vascular ectasia (GAVE). Despite being treated for GAVE, hemoglobin decreased gradually. Esophagogastroduodenoscopy (EGD) and colonoscopy revealed no source of bleeding. However, CE revealed a polyp at the distal duodenum. Barium meal and EGD revealed a lobulated and pedunculated polyp in the third portion of the duodenum. The polyp was treated with snare polypectomy. Histopathological examination of the polyp revealed hyperplasia. After treatment of the polyp, the anemia improved gradually. To our knowledge, there are only 6 reported cases of a duodenal hyperplastic polyp, including our case. The polyp was pedunculated in only 2 cases and lobulated only in our case. Moreover, our case was diagnosed by CE. When a patient presents with anemia or obscure gastrointestinal bleeding undiagnosed by EGD and colonoscopy, CE is useful for detecting the bleeding lesion.
authors.affiliation: Third Department of Internal Medicine, Nara Medical University, Kashihara, Nara, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Kawaratani
authors.forename: Tatsuhiro
authors.initials: T
authors.lastname: Tsujimoto
authors.forename: Norihisa
authors.initials: N
authors.lastname: Nishimura
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Taniguchi
authors.forename: Yusaku
authors.initials: Y
authors.lastname: Shirai
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kin
authors.forename: Masaki
authors.initials: M
authors.lastname: Nakayama
authors.forename: Hisao
authors.initials: H
authors.lastname: Fujii
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fukui