RESOLUTION OF A METAPLASTIC DUODENAL POLYP AFTER CURE OF HELICOBACTER-PYLORI INFECTION

Although there have been several reports of hyperplastic gastric polyp s associated with persistent Helicobacter pylori gastritis, the associ ation of H. pylori infection with metaplastic polyps in the duodenum h as not hitherto been described. After a 52-year-old man had a single e pisode of hematemesis, endos copy showed a smooth polyp 1 cm in greate st dimension formed by a proliferation of gastric epithelial cells of fundic and antral type found in the duodenal bulb. The outer surface w as entirely covered with a single layer of hyperplastic columnar epith elium with many H. pylori organisms. After administration of metronida zole 500 mg, omeprazole 20 mg for 4 weeks, and clarithromycin 250 mg t wice a day for 2 weeks, endoscopy showed a decrease in size of the duo denal polyp. At 12 weeks there was complete regression of the polyp. T his report documents a new and unusual finding: resolution of a gastri c metaplastic polyp in the duodenum associated with cure of H. pylori.