Endoscopic resection of small-bowel submucosal nodule

The options for management of submucosal nodules in the small bowel are limited.

A 67-year-old woman presented for evaluation after positive findings from fecal immunochemical testing. Colonoscopy showed a 2-cm submucosal nodule in the terminal ileum. Superficial biopsies from the lesion were unrevealing. Over-the-scope clip (OTSC)-assisted resection was planned. An OTSC (size 12/6, type gc) was applied to the base of the lesion and hot snare resection was performed above the clip ([Fig. 1], [Video 1]). The collected tissue was submitted for pathological examination, which showed lipoma. No procedure-related complications were seen.

Fig. 1 Hot snare resection of submucosal nodule in the terminal ileum, after placement of an over-the-scope (OTSC) clip at the base of the lesion.

Endoscopic resection of small-bowel submucosal nodule.

We conclude that OTSC-assisted resection is a safe management option for submucosal nodules in the small intestine.

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