Brunner's gland hamartoma: a case report and review of literature.

BACKGROUND: Brunner's hamartoma is a quite rare neoformation whose origin is not completely clear. METHODS: A case of a 69-year-old man with recurrent epigastric pain and an endoscopic finding of a duodenal mass is reported. RESULTS: The complete removal of hamartoma can give a complete remission of symptoms. CONCLUSIONS: Hamartoma can be only diagnosed by endoscopy and histological exam; its therapy is always surgical, also in order to avoid possible malignant degeneration.

[The ultrasound microbubble contrast in the diagnosis and the decisional iter of the treatment of the traumatic spleen lesions]. / L'ecografia con mezzo di contrasto nella diagnosi e nell'iter decisionale del trattamento delle lesioni traumatiche spleniche.

AIM OF THE STUDY: To estimate our 3-year experience on the diagnosis and monitoring of the spleen traumatic lesions with the employment of ultrasound microbubbles contrast. METHOD: From the 174 patients who were joints to our department in regimen of urgency for abdominal traumatic lesions, we have estimated 24 patiens including our criteria. The selected patients have been subordinate to the echographic examination with microbubbles contrast and to TC multi-detector (MDCT) with contrast with multiphasic technique. RESULTS: The echographic examination has evidenced 4 patients with abdominal fluid deposit without spleen parenchimal damage and 8 patients with morphofunctional alterations of the spleen. After the introduction of the contrast in 12 patients it has been evidenced a homogenous enhancement of the spleen parenchyma and in the remaining 12 patients the enhancement has turned out dishomogenous. From 24 patients examinated with CT with contrast, the traumatic breach of the spleen was demonstrated in same the 12 patients. CONCLUSION: It comes noticed the increased sensibility of the methodical CT with contrast and microbubbles contrast, that reaches up the 100% respect of the traditional echography whose sensibility turns out 66%. The CT remains the methodical gold-standard for the spleen traumatic lesions. Our experience suggests that the microbubbles contrast introduces the same one sensibility and it is preferred for follow-up and the corrected management of the patient.