Giant fibroid duodenal polyp causing serious anaemia

Introduction:

A giant fibroid polyp causing serious gastrointestinal bleeding for several years due to the diagnostic difficulties is reported. It took 6 years to get to the diagnosis from the first symptoms. Solution: surgical resection.

Case report:

The patient is a 70 years old male person. In 2002 investigations were started because of dyspnoe. It turned up that he has microciter anaemia and lack of ferrous sulphate, which was treated conservatively with success. Gastroscopy was negative. Within 4 years several investigations were made to find the exact reason for his recurrent anaemia, no organic cause could be revealed. The first time in 2006 when occult blood was discovered in his stool it was said to be due to occasionally bleeding piles.

Results:

In 2008 he received 12 units of blood transfusion in a month because of excessive anaemisation. After several negative gastroscopies at the end a solid polyp was discovered at the postbulbar region in the duodenum. It was checked and confirmed by capsule endoscopy.

Surgery was performed: a giant polyp (9×3cm) was removed from the dorsal side of the duodenal wall.

Discussion

The diagnosis of occult gastrointestinal bleeding is still to be resolved due to the lack of financial, trade and material conditions.