Approach to the endoscopic resection of duodenal lesions

Figure 6 A 53-year-old man presented with exertional dyspnea and 2 wk of melena. For symptomatic anemia, he received 8 units of packed red blood cells over several days. Upper endoscopy showed a 3.5-cm pedunculated polyp on a wide stalk in the posterior duodenal bulb (A, B); An endoloop was placed using a duodenoscope (C) followed by en to snare resection; The resected polyp was so large the bite block had to be removed in order to pull the polyp out of the mouth (D). Pathology showed a Brunner’s gland “adenoma”.