Year 2022 / Volume 114 / Number 5
Letter
Successful endoscopic removal of a giant duodenal bulb mass

298-299

DOI: 10.17235/reed.2022.8595/2022

Jie Zhang, Yuyong Tan, Yongjun Wang, Deliang Liu,

Abstract
A 53-year-old man presented to our hospital for resection of a duodenal mass because of the increasing diameter. Esophagogastroduodenoscopy revealed a giant oval mass in the back wall of duodenal bulb, which was protruded to the second part of duodenum(Figure 1). Endoscopic ultrasonography (EUS) revealed a submucosal mass with heterogeneous echogenicity and regular shape(Figure 2). Eventually, the patient received endoscopic submucosal dissection (ESD) after signing informed consent. The mass was resected completely and measured 6.0×4.2×3.0 cm [Figure 3]. Histopathological examination revealed a brunner’s gland adenoma. There was no complication besides minor intraoperative bleeding. Both surgery and endoscopic resection (ER) are alternative treatments for duodenal adenoma, but the best way remains controversial. Due to the thin wall, narrow cavity and plentiful vascular network of the duodenal bulb, ER is challenging because of the technical difficulty and probability of perforation and bleeding [1]. Our previous study found that ER is an effective and safe way for treating duodenal adenoma on experienced hands, and ER possesses several advantages over surgical resection for selected patients [2,3]. In the present case, we removed the giant BGA by ESD, as far as we know, this is the largest yet removed by ER.
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References
1. Li C, Chu Y, Lv L, et al. Safety and efficacy of endoscopic resection for the treatment of duodenal subepithelial lesions. Journal of Gastrointestinal Oncology 2021;12:856-63.
2. Li C, Liang C, Wang X, et al. Safety and efficacy of surgical and endoscopic resection in the treatment of duodenal subepithelial lesions. Surgical Endoscopy 2021.doi: 10.1007/s00464-021-08740-3.
3. Li DF, Shi R Y, Xiong F, et al. Endoscopic resection in combination with ligation for the treatment of duodenal subepithelial lesions: a single-center experience. Rev Esp Enferm Dig 2021. doi: 10.17235/reed.2021.8105/2021.
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Zhang J, Tan Y, Wang Y, Liu D. Successful endoscopic removal of a giant duodenal bulb mass. 8595/2022


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Publication history

Received: 11/01/2022

Accepted: 12/01/2022

Online First: 14/01/2022

Published: 06/05/2022

Article Online First time: 3 days

Article editing time: 115 days


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