胃十二指肠息肉

                               
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An 80 year old lady presented with upper GI bleed a year ago at another hospital. Gastroscopy showed a gastroduodenal polyp which was not resected. She now has troublesome angina and the cardiologists want to perform coronary angiography and probable PCI followed by dual anti-platelet therapy. She was therefore referred for removal of the polyp prior to coronary angiography.

At OGD, performed by a colleague, a 25mm polyp was found at the pylorus prolapsing into the duodenum. The polyp started to bleed whilst it was being resected. The attempt was aborted and the base of the polyp was injected with adrenaline and two clips were applied to arrest the bleeding. A second OGD was performed two days later...