PROSPECTIVE-STUDY OF PREVALENCE AND ENDOSCOPIC AND HISTOPATHOLOGIC CHARACTERISTICS OF DUODENAL POLYPS IN PATIENTS SUBMITTED TO UPPER ENDOSCOPY

Background: Retrospective studies of duodenal polyps have shown a prev alence of 0.3%-1.5% in patients referred to upper endoscopy, and histo pathologic classifications have been inconsistent. Methods: A prospect ive consecutive study was carried out in 584 patients referred to diag nostic upper endoscopy. Symptoms were registered on a questionnaire, e ndoscopic and histopathologic finding on standard forms. The same path ologist evaluated all biopsy specimens. Results: Twenty-seven patients had polyps in the first and/or second part of the duodenum, for a pre valence 4.6%. Sixteen polyps were either inflammatory (nine polyps) or ectopic gastric mucosa (seven polyps). Both of these polyp types were practically always non-solitary, sessile, small: and located in the d uodenal bulb. Seven polyps were covered by normal mucosa, three being endoscopically typical lipomas. Two polyps were adenomas (0.4% of all the patients and 7% of the polyps), and both were found in the descend ing part. One hyperplastic polyp of the gastric type and one case of f ibrosis were found. Conclusions: 1) Duodenal polyps are found in 4.6% of patients referred to upper endoscopy and should therefore be looked for. 2) Multiple, small polyps in the duodenal bulb are always benign and need neither biopsy nor treatment (in patients with familial poly posis biopsy is recommended). 3) In the descending duodenum polyps are rare, but a substantial number of them are adenomas. Biopsy is theref ore mandatory in this localization.