Duodenal pyloric gland adenoma with a long pedicle causes intestinal obstruction: A case report

The diagnosis of pyloric gland adenoma (PGA) can be challenging when a small lesion grows in an uncommon site, which has no characteristic imaging manifestations. However, radiological examination has specific value in the diagnosis of complications. PGA has a clear malignant potential, and its treatment depends on the size, shape, and location of the lesion. Minimally invasive endoscopic resection is an effective treatment option for this condition. This report aims to raise awareness among clinicians regarding such clinical scenarios.

In the current report, we present the case of a 28-year-old male patient with a duodenal pyloric adenoma with a long pedicle of >8 cm, causing intestinal obstruction and intermittent gastrointestinal bleeding. Finally, the tumor was completely removed endoscopically.

The pathological diagnosis result was (duodenum) pyloric gland adenoma, with some glands exhibiting mild to moderate dysplasia.

The patient underwent a hot trap resection of duodenal long-pedunculated polyps combined with nylon ropes and titanium clips. The operation was carried out under general anesthesia and lasted approximately 40 minutes, excluding the waiting time for anesthesia recovery. The tumor was discolored due to ischemia and was resected using high-frequency electrical resection.

The patient was discharged on the 7th day after polyp resection. The patient recovered well after surgery and no recurrence was observed during follow-up.

PGAs are usually solitary in the gastric body and rarely occur in the duodenum, and the appearance of a long pedicle have rarely been reported. Considering that PGA has definite malignant potential and may cause intestinal obstruction, early diagnosis and minimally invasive endoscopic resection are conducive to good prognosis.