Non-surgical treatment of a giant ileal lipoma by endoloop ligation (loop-and- let-go)

Endoloop (detachable snare loop) was first developed by Pontecorvo and Pesce in 1986 (1). It is mainly used in the endoscopic mechanical hemostasis of postpolypec- tomy bleeding. Herein we present a novel application of endoloop ligation and review some important hints about its use. A 56-year-old man underwent colonoscopy at another hospital because of hematochezia necessitating two units of blood transfusion which showed a giant ileal peduncu- lated polyp. Biopsies revealed non-specific findings. He was referred to our hospital for surgical treatment. Colo- noscopy demonstrated that the polyp was originating approximately from the last 10th cm of the terminal ileum, had a thick stalk, extending through the ileocecal valve into the proximal ascending colon and filling approxi- mately half of its volume. It had a smooth and patchy hyperemic-hemorrhagic surface. After giving informa- tion about the advantage and disadvantages of the proce- dure and obtaining consent of the patient, the polyp was tightly ligated at the base of its stalk by using an endoloop (MAJ-254, Olympus) through a standart, single accesso- ry channel colonoscope. Polyp mucosa was congested soon after after ligation. The procedure was performed in an outpatient setting and no immediate complications were observed. The patient was discharged one hour after the procedure and informed to follow his stool and bring the polyp in a biopsy specimen bottle.