Pedunculated Duodenal Lipoma Treated with Endoscopic Polypectomy with a Detachable Snare

We report endoscopic polypectomy with a detachable snare in a patient with a hemorrhagic pedunculated duodenal lipoma. A 67-year-old man with a history of spinal canal stenosis was admitted to our hospital because of recurrent tarry stools and anemia. Esophagogastro- duodenoscopy revealed a pedunculated submucosal tumor measuring approximately 4 cm, in the second part of the duodenum. The tumor had a slightly yellowish coloration, and longitudinal erosion was noted on the surface of the tumor. There were no significant findings in the esophagus, stomach and bulbs. Barium study revealed a pedunculated submucosal tumor measuring 40 × 12 mm in the second portion of the duodenum. We judged that the submucosal tumor may have been the hemorrhagic source, and removed it by endoscopic snare polypectomy with a detachable snare. No complications occurred during endoscopic procedures. Histopathological examination revealed that the tumor was composed of mature adipose tissue in the submucosa, which was consistent with a diagnosis of lipoma. In our experience, endoscopic polypectomy with a detachable snare is useful for the treatment of hemorrhagic pedunculated duodenal lipoma.