Abstract Text 45-year-old patient anticoagulated with acenocoumarol who was admitted for upper
gastrointestinal bleeding secondary to a 20 mm ulcerated pedunculated lesion located
in the duodenal bulb.
Endoscopic ultrasound showed a hyperechoic lesion with a heterogeneous central area
dependent on the second layer and with intravenous contrast uptake [1]
[2].
With suspicion of Gist, endoscopic removal was decided.We performed prophylactic mecanical
hemostasis with an Endoloop and then injection with 1:10000 adrenaline. Clip traction
was performed previous to en bloc resection by ESD (SB Knife+Splash Knife). Prophylactic
clip closure was done. The histology was compatible with Brunner's gland adenoma.
Video
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