There are several possible causes of duodenal bulge: first, duodenal polyps, which often originate from the mucosal layer or mucosal muscle layer, with smooth surface and obvious borders, the size of most polyps is about 1 cm, such polyps may appear local surface congestion, edema, as long as the endoscopic minimally invasive treatment, that is, EMR treatment, most of them can achieve clinical Most of them can be cured clinically with endoscopic minimally invasive treatment, that is, EMR. Second, duodenal smooth muscle tumor or mesenchymal tumor, which often originates from the mucosal muscle layer or intrinsic muscle layer, most of them do not have obvious borders, and they are relatively flat when inflated under gastroscopy, but more obvious after inspiration, and the submucosal elevation often has a smooth surface without obvious borders. Cure the situation. Third, duodenal papillae, which often originate in different locations and are often misdiagnosed as duodenal bulges, are mostly normal. The diagnosis of duodenal augmentation in the descending duodenum needs to be further assisted by ultrasound endoscopy.