Duodenal adenoma diagnosed by capsule endoscopy

An asymptomatic 80-year-old man─who had been taking low-dose aspirin for more than ten years─was recruited for surveillance endoscopy of small intestinal lesions caused by aspirin. Capsule endoscopy was performed, identifying a duodenal adenoma. Laboratory data at this point revealed no abnormal findings. The patient then initially underwent upper gastrointestinal endoscopy and colonoscopy but the lesion could not be observed. Single-balloon endoscopy revealed an elevated flattened lesion─10 mm in size with a central ulcer─in the 4th portion of the duodenum. Endoscopic mucosal resection (EMR) was performed. Histopathological diagnosis was tubular adenoma with moderate dysplasia. This case suggests that capsule endoscopy may be a useful diagnostic tool in the screening of small intestinal lesions.