Brunner’s gland hyperplasia: An unusual cause of gastrointestinal bleeding

IRSHAD, Ifal; WANI, Mohd Lateef; MALIK, Ajaz Ahmad; MALIK, Raid Ahmad

Brunner’s gland hyperplasia: An unusual cause of gastrointestinal bleeding

Ajaz Ahmad MALIK, (Department of Surgery, Sher-i-Kashmir Institute Of Medical Sciences Srinagar Kashmir, Srinagar, India)

Mohd Lateef WANI, (Department of Surgery, Sher-i-Kashmir Institute Of Medical Sciences Srinagar Kashmir, Srinagar, India)

Raid Ahmad MALIK, (Department of Surgery, Sher-i-Kashmir Institute Of Medical Sciences Srinagar Kashmir, Srinagar, India)

Ifal IRSHAD (Department of Surgery, Sher-i-Kashmir Institute Of Medical Sciences Srinagar Kashmir, Srinagar, India)

Turkish Journal of Gastroenterology

49 3

Yıl: 2011 Cilt: 22 Sayı: 4 Sayfa Aralığı: 419 - 421 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Brunner’s gland hyperplasia: An unusual cause of gastrointestinal bleeding

Öz:

Gastrointestinal kanama ile kendini gösteren Brunner bezi hiperplazisi olgusu burada sunulmuştur. Üst gastrointestinal kanama bulguları olan 40 yaşında erkek hasta, hastanemize müracaat etti. Hastanın son iki gündür siyah katran şeklinde dışkılama öyküsü mevcut idi. Yapılan üst gastrointestinal endoskopide duodenumun 2. kısım tabanında aktif kanama olan saplı polipoid lezyon gösterildi. Kanayan alan çevresine adenalin enjeksiyonu yapıldı. Fakat hasta kanamaya devam etti. Hasta cerrahiye alındı. Laparotomi uygulandı. Duodenum serbestleştirilip açıldı. Tabanından kanayan yaklaşık olarak 2 cm boyutunda büyük saplı polip bulundu. Polipektomi uygulandı. Örneğin histopatolojik incelemesinde yüzeyinde normal duodenum mukozası bulunduran normal Brunner bezi gösterildi. Tanı Brunner bezi hiperplazisi olarak yapıldı. Hasta semptomsuz olarak takip altındadır.

Anahtar Kelime:

Konular: Cerrahi

Brunner bezi hiperplazisi: Nadir bir gastrointestinal kanama sebebi

Öz:

A case of Brunner’s gland hyperplasia presenting as gastrointestinal bleeding is reported herein. A 40-year-old male presented to our hospital with features of upper gastrointestinal bleeding. The patient had a history of passing black tarry stools for the last two days. Upper gastrointestinal endoscopy was done, which showed a pedunculated polypoid lesion in the second part of the duodenum with active bleeding at the base of the polyp. Adrenaline was injected around the bleeding site; however, the patient continued to bleed. He was taken for surgery. A laparotomy was done, and the duodenum was mobilized and opened. A large pedunculated polyp measuring approximately 2 cm was found with bleeding at the base. Polypectomy was done. Histopathological examination of the specimen showed mature Brunner’s gland with normal duodenal mucosa at the surface. Diagnosis of Brunner’s gland hyperplasia was made. The patient is under follow-up and is symptom-free.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Levine JA, Burgart LJ, Batts KP, Wang KK. Brunner's gland hamartomas: clinical presentation and pathological features of 27 cases. Am J Gastroenterol 1995; 90: 290-4.
2. Patel ND, Levy AD, Mehrotra AK, Sobin LH. Brunner's gland hyperplasia and hamartoma: imaging features with clinicopathologic correlation. AJR Am J Roentgenol 2006; 187: 715-22.
3. Chattopadhyay P, Kundu AK, Bhattacharyya S, Bandyopadhyay A. Diffuse nodular hyperplasia of Brunner's gland presenting as upper gastrointestinal hemorrhage. Singapore Med J 2008; 49: 81-3.
4. Nakanishi T, Takeuchi T, Hara K, Sugimoto A. A great Brunner's gland adenoma of the duodenal bulb. Dig Dis Sci 1984; 29: 81-5.
5. Gao YP, Zhu JS, Zheng WJ. Brunner's gland adenoma of the duodenum: a case report and literature review. World J Gastroenterol 2004; 10: 2616-7.
6. Patel ND, Levy AD, Mehrotra AK, Sobin LH. Brunner's gland hyperplasia and hamartoma: imaging features with clinicopathologic correlation. AJR Am J Roentgenol 2006; 187: 715-22.
7. Schluger LK, Rotterdam H, Lebwohl O. Gastrointestinal hemorrhage from a Brunner's gland hamartoma. Am J Gastroenterol 1994; 89: 2088-9.
8. Walden DT, Marcon NE. Endoscopic injection and polypectomy for bleeding Brunner's gland hamartoma: case report and expanded literature review. Gastrointest Endosc 1998; 47: 403-7.
9. Perez A, Saltzman JR, Carr-Locke DL, et al. Benign nonampullary duodenal neoplasms. J Gastrointest Surg 2003; 7: 536-41.
10. Christie AC. Duodenal carcinoma with neoplastic transformation of the underlying Brunner's glands. Br J Cancer 1953; 7: 65-7.
11. Fujimaki E, Nakamura S, Sugai T, Takeda Y. Brunner's gland adenoma with a focus of p53-positive atypical glands. J Gastroenterol 2000; 35: 155-8.
12. de Nes LC, Ouwehand F, Peters SH, Boom MJ. A large Brunner's gland hamartoma causing gastrointestinal bleeding and obstruction. Dig Surg 2007; 24: 450-2.
13. Kehl O, Buhler H, Stamm B, Amman RW. Endoscopic removal of a large, obstructing and bleeding duodenal Brunner's gland adenoma. Endoscopy 1985; 17: 231-2.
14. Block KP, Frick TJ, Warner TF. Gastrointestinal bleeding from a Brunner's gland hamartoma: characterization by endoscopy, computed tomography, and endoscopic ultrasound. Am J Gastroenterol 2000; 95: 1581-3.

APA	MALIK A, WANI M, MALIK R, IRSHAD I (2011). Brunner’s gland hyperplasia: An unusual cause of gastrointestinal bleeding. , 419 - 421.
Chicago	MALIK Ajaz Ahmad,WANI Mohd Lateef,MALIK Raid Ahmad,IRSHAD Ifal Brunner’s gland hyperplasia: An unusual cause of gastrointestinal bleeding. (2011): 419 - 421.
MLA	MALIK Ajaz Ahmad,WANI Mohd Lateef,MALIK Raid Ahmad,IRSHAD Ifal Brunner’s gland hyperplasia: An unusual cause of gastrointestinal bleeding. , 2011, ss.419 - 421.
AMA	MALIK A,WANI M,MALIK R,IRSHAD I Brunner’s gland hyperplasia: An unusual cause of gastrointestinal bleeding. . 2011; 419 - 421.
Vancouver	MALIK A,WANI M,MALIK R,IRSHAD I Brunner’s gland hyperplasia: An unusual cause of gastrointestinal bleeding. . 2011; 419 - 421.
IEEE	MALIK A,WANI M,MALIK R,IRSHAD I "Brunner’s gland hyperplasia: An unusual cause of gastrointestinal bleeding." , ss.419 - 421, 2011.
ISNAD	MALIK, Ajaz Ahmad vd. "Brunner’s gland hyperplasia: An unusual cause of gastrointestinal bleeding". (2011), 419-421.

APA	MALIK A, WANI M, MALIK R, IRSHAD I (2011). Brunner’s gland hyperplasia: An unusual cause of gastrointestinal bleeding. Turkish Journal of Gastroenterology, 22(4), 419 - 421.
Chicago	MALIK Ajaz Ahmad,WANI Mohd Lateef,MALIK Raid Ahmad,IRSHAD Ifal Brunner’s gland hyperplasia: An unusual cause of gastrointestinal bleeding. Turkish Journal of Gastroenterology 22, no.4 (2011): 419 - 421.
MLA	MALIK Ajaz Ahmad,WANI Mohd Lateef,MALIK Raid Ahmad,IRSHAD Ifal Brunner’s gland hyperplasia: An unusual cause of gastrointestinal bleeding. Turkish Journal of Gastroenterology, vol.22, no.4, 2011, ss.419 - 421.
AMA	MALIK A,WANI M,MALIK R,IRSHAD I Brunner’s gland hyperplasia: An unusual cause of gastrointestinal bleeding. Turkish Journal of Gastroenterology. 2011; 22(4): 419 - 421.
Vancouver	MALIK A,WANI M,MALIK R,IRSHAD I Brunner’s gland hyperplasia: An unusual cause of gastrointestinal bleeding. Turkish Journal of Gastroenterology. 2011; 22(4): 419 - 421.
IEEE	MALIK A,WANI M,MALIK R,IRSHAD I "Brunner’s gland hyperplasia: An unusual cause of gastrointestinal bleeding." Turkish Journal of Gastroenterology, 22, ss.419 - 421, 2011.
ISNAD	MALIK, Ajaz Ahmad vd. "Brunner’s gland hyperplasia: An unusual cause of gastrointestinal bleeding". Turkish Journal of Gastroenterology 22/4 (2011), 419-421.