SUMMARY AimTo evaluate colorectal cancer risk among patients with sporadic duodenal neoplasia using a case-control protocol. MethodsCases were 35 patients referred for the management of sporadic duodenal adenoma and who underwent colonoscopy. Colonoscopy findings among cases were compared with those from a control group matched for age and sex (two controls per case) without duodenal adenoma. Colonoscopy findings were categorized as adenoma, advanced adenoma, cancer or advanced neoplasia. The two groups were compared using the chi-squared test. Odds ratio and 95% confidence intervals were calculated. ResultsColorectal adenoma was present in 31% of cases vs. 24% of controls, advanced neoplasia in 29% vs. 4%, advanced adenoma in 23% vs. 3% and adenocarcinoma in 6% vs. 1%. The relative risks of advanced colorectal adenoma and advanced colorectal neoplasia in cases were 10.1 (95% CI: 1.8-100.1, P = 0.003) and 8.9 (95% CI: 2.1-53.3, P = 0.001), respectively. ConclusionsThe relative risk of advanced colorectal adenoma and advanced neoplasia in cases was nine-to 10-fold that among controls. Patients with sporadic duodenal adenoma represent a high-risk group for advanced colorectal neoplasia and should therefore undergo complete colonoscopy.

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the case of a giant Brunner' s gland hamartoma of typically h ypodense appearance, which w as disco v ered fortuitously and successfully remov ed by endoscopic polypectomy using a diathermic snare with a detachable loop. W e describe the specific features of a hamartoma, despite the usual use of the term "Brunner' s gland adenoma".