Post written by Hiroko Nakahira, MD, from the Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan.

Underwater endoscopic mucosal resection (EMR) was performed for a large duodenal adenoma in a patient with familial adenomatous polyposis, and the mucosal defect after underwater EMR was closed with line-assisted complete closure technique.

Endoscopic mucosal resection for a large duodenal adenoma is considered to be risky and sometimes surgical operation is performed. Endoscopic submucosal dissection (ESD) is occasionally performed with a lengthy operation time and severe adverse events. We could indicate less-invasive endoscopic therapy for a large duodenal adenoma.

A large duodenal adenoma in a patient with familial adenomatous polyposis can be managed safely with underwater EMR and invasive surgery or risky endoscopic therapy can be avoided.

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