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Christmas Offerings

A finger in the duodenum

Hayley Clifford, Millie Lui, Roger Lee and Andrew Thomson
MJA 2009; 191 (11/12): 691

A 70-year-old man developed melaena after taking aspirin and clopidogrel for 2 months to treat ischaemic heart disease. Other medications the patient was taking included metformin and metoprolol. A lipoma, the endoscopic appearance of which resembled a finger (Figure), was the only endoscopic abnormality. It was resected endoscopically, with the aid of an endoloop to cut off its blood supply before removal with a snare. The diagnosis was histologically confirmed but ulceration was not found, possibly because one section of the lesion was not retrieved. Lipomas are soft and typically appear as an isolated bulge of smooth mucosa, often with a yellow hue. Such lesions bleed rarely.

Hayley Clifford, Intern1Millie Lui, Pathologist1Roger Lee, Gastroenterologist2Andrew Thomson, Gastroenterologist,1 and Clinical Senior Lecturer in Medicine3

1 Gastroenterology and Hepatology Unit, Canberra Hospital, Canberra, ACT.

2 Calvary Hospital, Canberra, ACT.

3 Australian National University, Canberra, ACT.

andrew.thomsonATact.gov.au

(Received 17 Apr 2009, accepted 27 Aug 2009)


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©The Medical Journal of Australia 2009 www.mja.com.au PRINT ISSN: 0025-729X ONLINE ISSN: 1326-5377