A 70-year-old woman was referred to our hospital because of persistent epigastric pain and severe hypochromic microcytic anemia (HB=
5.7). Upper digestive endoscopy was done and revealed two duodenal polyps (one in the bulb and the other at the junction between the bulb and the second part of duodenum). There are excessive whitish
secretions in the stomach and duodenum. Also, the endoscopy showed atrophic gastritis and gastric mucosal prolapse.
Notes:
Most duodenal polyps are inflammatory polyps and have ectopic gastric mucosa[1,2]. Multiple and small polyps in the duodenal bulb are always benign and need neither biopsy nor treatment; except in patients with familial polyposis, where routine upper gastrointestinal surveillance endoscopy and biopsy of the duodenal polyps are mandatory[3].Although most duodenal polyps had a benign clinical course(Brunner’s gland hyperplasia, Brunner’s gland hamartoma, ectopic gastric mucosa, ectopic pancreas, hyperplastic polyps, and inflammatory polyps), some of them can show malignant transformation into adenomas or carcinoid tumors.References:
1. Höchter W, Weingart J, Seib HJ, Ottenjann R. [Duodenal polyps. Incidence, histologic substrate and significance] Dtsch Med Wochenschr. 1984;109:1183–1186. [PubMed]
2. Reddy RR, Schuman BM, Priest RJ. Duodenal polyps: diagnosis and management. J Clin Gastroenterol. 1981;3:139–147. [PubMed]
3. Jepsen JM, Persson M, Jakobsen NO, Christiansen T, Skoubo-Kristensen E, Funch-Jensen P, Kruse A, Thommesen P. Prospective study of prevalence and endoscopic and histopathologic characteristics of duodenal polyps in patients submitted to upper endoscopy. Scand J Gastroenterol. 1994;29:483–487.[PubMed].
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