Aims Duodenal duplication is a rare congenital anomaly often diagnosed in childhood, butoccasionally
identified in adults. This study reports two cases of adult patientswith duodenal
duplications presenting with distinct polypoid lesions in theduodenum. Both cases
highlight the role of endoscopic ultrasound (EUS) indiagnosing and characterizing
duodenal duplications and associated lesions.
Methods Two patients, a 64-year-old female and a 57-year-old male, presented with uppergastrointestinal
symptoms and were referred for endoscopic evaluation. EUS andupper gastrointestinal
endoscopy were performed for detailed assessment.
Results Case 1: The 64-year-old female presented with hepatic metastases of unknown primary origin.Upper
gastrointestinal endoscopy revealed a large polypoid lesion (25-30 mm) in the secondpart
of the duodenum (DII) with lymphangiectasias and telangiectasias. EUS revealed ahyperechoic
neuroendocrine tumor measuring 24 x 13 mm originating from the submucosallayer, along
with a duodenal duplication measuring approximately 60 mm.
Case 2: The 57-year-old male presented with a large obstructing polyp in DII,along with symptoms
of gastroesophageal reflux. Endoscopy showed a polypoidlesion causing partial duodenal
obstruction, accompanied by a sliding hiatal herniaand Schatzki ring. EUS revealed
a duodenal duplication measuring 28 x 23 mmadjacent to the lesion.
Both cases confirmed the presence of duodenal duplications with associatedpolypoid
formations. EUS allowed for a clear differentiation of submucosal layersand assessment
of surrounding structures, which was essential for management.
Conclusions These cases underscore the importance of EUS in evaluating submucosal lesionsand
detecting rare anomalies like duodenal duplications in adults. Comprehensiveimaging
is crucial for accurate diagnosis and management, particularly in atypicalpresentations
such as neuroendocrine tumors or obstructive polyps in the contextof duplication.
