ASGE DDW Videos from Around the World | 2022-ENDOSCOPIC SUBMUCOSAL DISSECTION FOR DEFINITIVE MANAGEMENT OF A LARGE BLEEDING DUODENAL ANGIOLIPOMA

ENDOSCOPIC SUBMUCOSAL DISSECTION FOR DEFINITIVE MANAGEMENT OF A LARGE BLEEDING DUODENAL ANGIOLIPOMA

Video Transcription

Video Summary

This video showcases a case of endoscopic submucosal dissection (ESD) used to treat a large, bleeding duodenal angiolipoma in a 77-year-old woman. The patient initially presented with persistent melanoma and underwent various endoscopic procedures to identify the source of bleeding in her duodenum. Subsequently, ESD was performed to carefully resect the polyp, minimizing the risk of excessive bleeding. The procedure involved reducing the vascular supply with clips, using a scissor-type knife for the resection, and sealing and ligating large vessels within the polyp. The resected lesion was histologically confirmed as an angiolipoma. The patient was discharged and showed complete resolution of her symptoms. The video emphasizes the efficacy and safety of ESD for managing challenging duodenal polyps, specifically those that are large and pedunculated. It highlights the importance of careful planning, precise technique, and post-resection management to prevent complications.

Keywords

endoscopic submucosal dissection

duodenal angiolipoma

bleeding

ESD

challenging duodenal polyps