Diagnosis and endoscopic resection of a bleeding duodenal lipoma

The esophagus, stomach, and duodenal bulb are frequent sites for upper gastrointestinal bleeding. The distal duodenum or other areas of the small intestine are much less common locations for blood loss. Here, we report bleeding in a patient from a 4-cm lipoma in the third portion of the duodenum. The diagnosis of lipoma was strongly suspected from the CT scan and endoscopic features. Endoscopic polypectomy was done after epinephrine needle infiltration of the stalk base. Retrieval of the polyp was accomplished using a Roth Net (US Endoscopy, Mentor, OH). We describe our experience of this endoscopic resection technique being used for this rare cause of upper gastrointestinal bleeding.