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Hamartomatous gastric polyp A case report of atypical presentation Abstract Most gastric polyps have an asymptomatic presentation and are an incidental finding on upper endoscopy Symptomatic presentations can range from anemia and bleeding up to complete gastric outlet obstruction We present a case presented to us by jaundice vomiting And upper abdominal pain for 2 weeks ultrasound shows a picture of acute pancreatitis due to obstructive jaundice In upper endoscopy initially we find a large pedunculated gastric polyp passing through pyloric ring up to 2nd part of duodenum causing a compression on duodenal papilla It was withdrawn back to stomach after grasping with a snare Then removed by piecemeal technique after injection of the pedicle with diluted adrenaline Bleeding after snaring the pedicle was secured with injection of diluted adrenaline and a insertion of a haemoclip with complete resolution of all symptoms Introduction Gastric polyps are found in approximately 1 6 35 of endoscopies 1 Most of these cases are asymptomatic However large polyps can be presented by bleeding anemia or obstructive symptoms 2 Gastric hamartomatous polyps comprise about 1 of all the stomach polyps They can be presented solitary or as a part of a clinical syndrome 3 such as Peutz Jeghers syndrome PJS and juvenile polyposis solitary polyps are usually benign Except for inverted hamartomatous polyps GIHPs which have a 20 of malignant transformation while the symdromatic hamartomatous polyps has a higher malignancy risk which increases with age range 1 to 33 between 30 and 60 years 4 Gastric polyps may intussusept to duodenum causing gastric outlet obstruction
