Closure of a large post-endoscopic full-thickness resection defect in the duodenum using a novel through-the-scope twin clip

A 46-year-old man was admitted to our hospital with a 2.5-cm submucosal tumor in the duodenal bulb ([Fig. 1]). Enhanced computed tomography revealed a rounded abnormal enhancement in the duodenal bulb ([Fig. 2]). Endoscopic ultrasound showed a heterogeneous hypoechoic lesion originating from the muscularis propria with both intraluminal and extraluminal growth ([Fig. 3]). A submucosal injection was performed, followed by a mucosal incision around the intraluminal component of the tumor to expose the pseudocapsule.