Endoscopic Mucosectomy Case Study 1: Flat Duodenal Adenoma

Background

An 83-year-old male with a history of iron deficiency anemia underwent upper endoscopy and was found to have a 3 cm sessile adenoma in the second portion of the duodenum extending over two folds. Biopsies showed tubular adenoma without dysplasia. He was referred to IESMG for consideration of mucosectomy.

Treatment

Saline was injected into the submucosa to raise the adenoma from the underlying muscle layer. Piecemeal resection was performed using a monofilament mucosectomy snare. The resection margins were fulgurated with argon plasma coagulation.

Outcome

Follow-up endoscopy with biopsies six months later showed scarring with no residual or recurrent adenoma.