Endoclip placement at gastric polypectomy site

A 52 year old male was referred for nausea and vomiting. After initial evaluation, an endoscopy was performed which revealed a 3cm long pedunculated gastric polyp. The polyp originated in the pre-pyloric region of the stomach and prolapsed through the pylorus into the duodenal bulb. The polyp was resected using a hot snare. After the resection, a large secondary ulcer exposing the submucosa remained. Though there was no active bleeding, two endoclips were placed to close the defect completely. The patient was placed on twice daily esomeprazole and was given instructions to avoid NSAIDS and aspirin. No bleeding or other complications were noted during follow up. The pathology showed that this was an inflammatory polyp with features of high grade dysplasia.