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1.
Niger J Clin Pract ; 22(9): 1298-1300, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31489870

RESUMO

Brunner's gland adenoma is usually asymptomatic and sometimes accompanied by nausea, vomiting and swelling. It is often confused with duodenal malignancy, which may mislead and the physician about its treatment. We want to present a case of a 40-year-old female with a history of weight loss, vomiting and nausea since six months. Initial imaging studies that revealed a large mass in the duodenum and endoscopic findings that suggested duodenal invagination. Whipple operation had been recommended to the patient by two different general surgery departments. The patient reported to our clinic for gastroenterological evaluation before the operation. At our exmination, a giant polyp, 5 to 6 cm in size, was observed in the second part of the duodenum; it was 9 to 10 cm long and originated from the pylorus. Duodenotomy was performed, and only the giant polyp was removed. Pathological examination revealed hyperplastic Brunner's glands mixed with fibromuscular tissue and mature fat tissue.


Assuntos
Adenoma/patologia , Glândulas Duodenais/patologia , Neoplasias Duodenais/cirurgia , Duodenoscopia , Duodeno/diagnóstico por imagem , Piloro/diagnóstico por imagem , Adenoma/cirurgia , Adulto , Glândulas Duodenais/cirurgia , Neoplasias Duodenais/patologia , Feminino , Humanos , Resultado do Tratamento
2.
Intern Med ; 58(14): 2009-2013, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-30918195

RESUMO

A 57-year-old female was referred to our department for treatment of a duodenal submucosal tumor (SMT), which had been growing over the last five years. Computed tomography demonstrated a marginally enhanced mass, measuring 36 mm in diameter, containing internal multiple hypovascular areas. Endoscopic ultrasonography-guided fine needle biopsy was performed using a 20-gauge core trap needle, and the specimens showed benign Brunner's glands. She underwent laparoscopic endoscopic cooperative surgery and the SMT was completely removed without any adverse events. Histology of the resected tumor showed Brunner's gland hyperplasia (BGH). BGH is generally a benign lesion. However, an accurate diagnosis is required to avoid overtreatment when it mimics malignancy.


Assuntos
Glândulas Duodenais/diagnóstico por imagem , Glândulas Duodenais/cirurgia , Duodenopatias/diagnóstico por imagem , Duodenopatias/cirurgia , Hiperplasia/diagnóstico por imagem , Hiperplasia/cirurgia , Biópsia por Agulha Fina/métodos , Duodenopatias/patologia , Endossonografia/métodos , Feminino , Humanos , Laparoscopia/métodos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Resultado do Tratamento
4.
Pan Afr Med J ; 29: 78, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29875959

RESUMO

Brunner's Gland Adenoma is a very rarely seen benign tumor of duodenum. While it generally leads to obstruction and bleeding complaints, it may very rarely occur by mimicking a pancreatic tumor. A 48 years old male patient admitted to the gastroenterology clinic due to the epigastric pain spreading dorsally. No significant feature is present in his clinical history. A lesion containing cystic solid components in the size of 30x40 mm was detected in the head of pancreas as a result of the abdominal tomography. In the light of these findings, pancreaticoduodenectomy is applied to the patient. It is observed that tumor is in submucosal location and widely invaded the pancreatic head. In the histopathological examination, Brunner's Gland Adenoma is reported in pancreatic head localization. In this manuscript a case of Brunner's gland adenoma diagnosed by performing pancreaticoduodenectomy due to the mass in the head of the pancreas is presented.


Assuntos
Adenoma/diagnóstico , Glândulas Duodenais/patologia , Neoplasias Duodenais/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Adenoma/patologia , Adenoma/cirurgia , Glândulas Duodenais/cirurgia , Neoplasias Duodenais/patologia , Neoplasias Duodenais/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Pancreaticoduodenectomia/métodos , Tomografia Computadorizada por Raios X
5.
G Chir ; 39(2): 111-113, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29694312

RESUMO

AIM: To report a case of Brunner's gland hamartoma (BGH) in patient treated with surgical resection. CASE REPORT: A 73 years old male patient that was admitted with melena. The preoperative investigations suggested a suspected duodenal large polypoidal mass. A local resection was performed. Surgical resection is actually considered the best treatment for this lesion. DISCUSSION: Brunner's glands were first described by Brunner in 1688. Hamartoma designates an excessive focal overgrowth of mature normal cells and tissues, composed of identical cellular elements. Most patients with Brunner's gland hamartoma are asymptomatic or have nonspecific complaints. CONCLUSION: BHG is a rare tumor arising from the Brunner's gland of the duodenum, considered entirely benign, although there have been occasionally reports of malignant foci inside.


Assuntos
Glândulas Duodenais/cirurgia , Hamartoma/cirurgia , Idoso , Glândulas Duodenais/patologia , Duodenopatias/complicações , Duodenopatias/cirurgia , Hamartoma/complicações , Humanos , Masculino , Melena/etiologia
6.
BMJ Case Rep ; 20172017 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-28275018

RESUMO

A man aged 65 years presented with symptomatic anaemia without overt gastrointestinal bleeding. An oesophagogastroduodenoscopy (EGD) was performed and he was found to have a large ulcerated pedunculated Brunner's gland hamartoma in the duodenal bulb. The polyp was resected using snare cautery in forward and retroflexed positions. Colonoscopy was also performed and a few diminutive polyps were resected. A year later, the patient returned for a surveillance EGD, and no residual polyp was noted. Haemoglobin and iron studies normalised within a few months after polypectomy, with resolution of symptoms.


Assuntos
Glândulas Duodenais/patologia , Pólipos do Colo/cirurgia , Duodenopatias/etiologia , Hamartoma/etiologia , Idoso , Anemia Ferropriva , Glândulas Duodenais/cirurgia , Pólipos do Colo/diagnóstico , Duodenopatias/patologia , Duodenopatias/cirurgia , Hamartoma/patologia , Hamartoma/cirurgia , Humanos , Masculino , Resultado do Tratamento
7.
Ann R Coll Surg Engl ; 98(6): e92-3, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27055413

RESUMO

Introduction Brunner's glands are submucosal glands found in the duodenum. Proliferation of these glands can lead to the formation of Brunner's gland hamartomas (BGHs), which are uncommon, asymptomatic and usually found incidentally. They are predominantly benign lesions, but instances of malignant transformation have been reported. Case History We describe a rare case in which a periampullary lesion was causing biliary obstruction on a background of weight loss, and was associated with dilatation of the common bile duct and pancreatic duct on computed tomography and magnetic resonance imaging. Further investigation with endoscopic ultrasound and biopsy did not provide a definitive diagnosis. Given the symptoms and findings upon investigations, we proceeded to pylorus-preserving pancreatoduodenectomy. Conclusions This was a rare case in which BGH gave rise to biliary obstruction against a background of weight loss. Due to a high index of suspicion (weight loss and evidence of dilatation of the common bile duct and pancreatic duct), this procedure was justified because the consequences of a missed periampullary cancer far outweighed surgical risks.


Assuntos
Glândulas Duodenais/diagnóstico por imagem , Duodenopatias/diagnóstico por imagem , Hamartoma/diagnóstico por imagem , Glândulas Duodenais/cirurgia , Colestase/etiologia , Colestase/cirurgia , Duodenopatias/cirurgia , Feminino , Hamartoma/cirurgia , Humanos , Pessoa de Meia-Idade
10.
Ann R Coll Surg Engl ; 97(5): e70-2, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26264106

RESUMO

Brunner's gland hamartoma (BGH) is a rare benign tumour of the duodenum. We present a case of duodenal obstruction caused by a BGH, which required surgical resection after a failed attempt at endoscopic removal.


Assuntos
Glândulas Duodenais/patologia , Neoplasias Duodenais/patologia , Obstrução Duodenal/patologia , Hamartoma/patologia , Idoso , Glândulas Duodenais/cirurgia , Neoplasias Duodenais/cirurgia , Obstrução Duodenal/cirurgia , Feminino , Hamartoma/cirurgia , Humanos
11.
Int J Clin Exp Pathol ; 8(6): 7565-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26261670

RESUMO

Brunner's gland adenoma is a rare tumor of the duodenum and might also be an unusual cause of gastrointestinal bleeding or obstruction. The pathogenesis of Brunner gland hamartoma of the duodenum is unknown. We report two cases of Brunner's gland adenoma. Surgical resection was carried out because the tumor size was big in both cases and one accompanied with bleeding. Pathological examination revealed submucosal nodular hyperplasia of the Brunner's glands.


Assuntos
Adenoma/patologia , Glândulas Duodenais/patologia , Neoplasias Duodenais/patologia , Adenoma/complicações , Adenoma/cirurgia , Adulto , Biópsia , Glândulas Duodenais/cirurgia , Neoplasias Duodenais/complicações , Neoplasias Duodenais/cirurgia , Duodenoscopia , Endossonografia , Feminino , Hemorragia Gastrointestinal/etiologia , Humanos , Hiperplasia , Masculino , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Carga Tumoral
14.
Ultraschall Med ; 33(7): E210-E217, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23129520

RESUMO

PURPOSE: Duodenal tumors are rare and require a different management from that of esophagogastric neoplasia. The present study retrospectively analyses the endoscopic ultrasound (EUS) features of duodenal tumors of both epithelial and subepithelial origin. MATERIALS AND METHODS: During a 12 year period, all duodenal tumors with histologic confirmation by surgery or biopsy were collected including endoscopic and endosonographic images. EUS images were analyzed for specific features (echogenicity, wall layer structure and relation, outer margins) to possibly distinguish epithelial (polyps and carcinoma versus lymphoma) and subepithelial (tumor type) tumors. RESULTS: 53/80 cases had histologic confirmation (mean age 53.1 ±â€Š11.4 years, m:f = 33:20), 31 were epithelial (13 adenomas, 12 carcinomas, 6 lymphomas) and 22 subepithelial (11 GISTs, 7 Brunneromas, 1 lipoma, 3 NETs). EUS did not recognize carcinomas in 2/13 adenomas. EUS features suggesting carcinoma were loss of wall layers and irregular margins. 5/6 lymphomas showed inhomogeneous thickening with layers partially recognizable. Tumor type of subepithelial lesions correlated with echogenicity: GIST tumors were mostly (62.5 %) hypocheoic with the 3 malignant cases being characterized by heterogeneous echopattern with irregular outer margins. Of the hyperechoic lesions, lipomas had a homogeneous whitish appearance, while NET and Brunneromas were less hyperechoic. In the latter, the endoscopic aspect was also helpful for differential diagnosis. Accuracy of combined endoscopic/EUS imaging for all duodenal lesions was 84.9 % (45/53). No procedural complications occurred among all patients that received EUS examinations. CONCLUSION: EUS contributes to the differential diagnosis of epithelial lesions known to be malignant; in subepithelial tumors, tissue confirmation is still required.


Assuntos
Neoplasias Duodenais/diagnóstico por imagem , Endossonografia/métodos , Interpretação de Imagem Assistida por Computador/métodos , Adenoma/diagnóstico por imagem , Adenoma/patologia , Adenoma/cirurgia , Adolescente , Adulto , Idoso , Glândulas Duodenais/diagnóstico por imagem , Glândulas Duodenais/patologia , Glândulas Duodenais/cirurgia , Carcinoma/diagnóstico por imagem , Carcinoma/patologia , Carcinoma/cirurgia , Diagnóstico Diferencial , Neoplasias Duodenais/patologia , Neoplasias Duodenais/cirurgia , Feminino , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Tumores do Estroma Gastrointestinal/patologia , Tumores do Estroma Gastrointestinal/cirurgia , Humanos , Hiperplasia , Pólipos Intestinais/diagnóstico por imagem , Pólipos Intestinais/patologia , Pólipos Intestinais/cirurgia , Lipoma/diagnóstico por imagem , Lipoma/patologia , Lipoma/cirurgia , Linfoma/diagnóstico por imagem , Linfoma/patologia , Linfoma/cirurgia , Masculino , Pessoa de Meia-Idade , Tumores Neuroendócrinos/diagnóstico por imagem , Tumores Neuroendócrinos/patologia , Tumores Neuroendócrinos/cirurgia , Sensibilidade e Especificidade , Adulto Jovem
15.
J Laparoendosc Adv Surg Tech A ; 22(9): 904-9, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23057621

RESUMO

OBJECTIVES: Brunner's adenoma is a rare benign tumor of the duodenum. The traditional management option was close follow-up and surgical tumor resection. With the development of endoscopy devices and techniques, endoscopic resection is considered an alternative treatment option. However, whether small lesions require treatment has been controversial. We planned to study the feasibility, efficacy, and safety of endoscopic resection for the treatment of Brunner's adenomas. SUBJECTS AND METHODS: In total, 30 Brunner's adenomas from 29 patients were treated with endoscopic resection between August 2007 and June 2011 in our hospital. Endoscopic ultrasonography (EUS) was performed preoperatively to evaluate tumor origin and size. Tumor characteristics, complications, en bloc resection rate, and local recurrence rates were evaluated. RESULTS: Of the 29 patients, 13 (44.8%) were men. The median age was 55 years (range, 29-72 years). The mean maximal dimension of the lesions was 1.7±0.1 cm (range, 0.6-7 cm). Overall, 9 lesions were treated with snare resection, 12 lesions were treated with conventional endoscopic mucosal resection (EMR), and 9 lesions were treated with endoscopic submucosal dissection (ESD). Only 1 case of delayed bleeding occurred on Day 2 after EMR. The en bloc resection rate was 100% (30/30). One lesion resected by EMR exhibited indeterminate tumor margins. The overall curative resection rate was 96.7% (29/30). During the follow-up period (median time, 13 months; range, 2-39 months), 1 patient, whose tumor exhibited indeterminate margins, showed recurrence 1 year after EMR; ESD was recommended. No recurrence was observed during the subsequent follow-up period. CONCLUSIONS: Our study provides evidence of the efficacy of endoscopic resection for the localized treatment of duodenal Brunner's gland adenomas with relatively few complications and a low mortality rate.


Assuntos
Adenoma/cirurgia , Glândulas Duodenais/cirurgia , Neoplasias Duodenais/cirurgia , Endoscopia Gastrointestinal/métodos , Adenoma/diagnóstico por imagem , Adenoma/mortalidade , Adenoma/patologia , Adulto , Idoso , Glândulas Duodenais/diagnóstico por imagem , Glândulas Duodenais/patologia , Neoplasias Duodenais/diagnóstico por imagem , Neoplasias Duodenais/mortalidade , Neoplasias Duodenais/patologia , Endossonografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estudos Retrospectivos
17.
Hepatobiliary Pancreat Dis Int ; 11(1): 107-10, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22251478

RESUMO

BACKGROUND: Brunner's gland adenoma (BGA) is an unusual benign neoplasm arising from Brunner's glands in the duodenum. When symptomatic it presents either with duodenal obstruction or bleeding. However, pancreatitis secondary to ampullary obstruction from a BGA is very rare. METHODS: A 23-year-old female presented with recurrent episodes of "idiopathic" pancreatitis. She was extensively investigated and was found to have a large polypoid BGA, intermittently obstructing the ampulla. This created a ball-valve effect causing secondary intermittent obstruction of the pancreatic duct resulting in pancreatitis. The condition was cured surgically, through transduodenal excision of the BGA. We reviewed the surgical literature pertaining to these unusual and similar causes of obstructive pancreatitis, not related to gallstones. RESULTS: BGA of the duodenum is a rare cause of pancreatitis. Extensive investigations should be carried out in all cases of unexplained pancreatitis before classifying the condition as "idiopathic". Discovery of a lesion of this nature gives an opportunity to provide a permanent surgical cure. CONCLUSIONS: BGA adds an unusual etiology for pancreatitis. All patients with pancreatitis should undergo extensive investigations before being termed "idiopathic". Surgical excision of the BGA provides a definitive curative treatment for the adenoma and pancreatitis.


Assuntos
Adenoma/complicações , Glândulas Duodenais , Colestase/etiologia , Neoplasias Duodenais/complicações , Pólipos Intestinais/complicações , Pancreatite/etiologia , Adenoma/diagnóstico , Adenoma/cirurgia , Ampola Hepatopancreática/patologia , Glândulas Duodenais/patologia , Glândulas Duodenais/cirurgia , Colestase/cirurgia , Neoplasias Duodenais/diagnóstico , Neoplasias Duodenais/cirurgia , Endoscopia Gastrointestinal , Feminino , Humanos , Pólipos Intestinais/diagnóstico , Pólipos Intestinais/cirurgia , Pancreatite/cirurgia , Recidiva , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto Jovem
18.
J Small Anim Pract ; 53(2): 136-9, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22129371

RESUMO

An eight-year-old, neutered, female English springer spaniel was presented with a 14-month history of vomiting, marked weight loss and lethargy, all of which were non-responsive to medical therapy. Abdominal radiographs and ultrasonography showed an intraluminal soft tissue mass extending from the pyloric antrum to the proximal duodenum. Two spherical masses both approximately 8 cm in diameter were removed via a duodenotomy. Histopathological examination showed the first mass to be a trichobezoar and the aboral mass to be a Brunner's gland adenoma. Surgery resulted in a complete resolution of the clinical signs.


Assuntos
Adenoma/veterinária , Bezoares/veterinária , Glândulas Duodenais , Doenças do Cão/diagnóstico , Neoplasias Duodenais/veterinária , Adenoma/complicações , Adenoma/diagnóstico , Adenoma/cirurgia , Animais , Bezoares/complicações , Bezoares/diagnóstico , Bezoares/cirurgia , Glândulas Duodenais/patologia , Glândulas Duodenais/cirurgia , Doenças do Cão/cirurgia , Cães , Neoplasias Duodenais/complicações , Neoplasias Duodenais/diagnóstico , Neoplasias Duodenais/cirurgia , Obstrução Duodenal/etiologia , Obstrução Duodenal/cirurgia , Obstrução Duodenal/veterinária , Feminino , Resultado do Tratamento
19.
Turk J Gastroenterol ; 22(4): 419-21, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21948574

RESUMO

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.


Assuntos
Glândulas Duodenais/patologia , Hemorragia Gastrointestinal/etiologia , Pólipos Intestinais/etiologia , Adulto , Glândulas Duodenais/cirurgia , Endoscopia Gastrointestinal , Hemorragia Gastrointestinal/diagnóstico , Humanos , Hiperplasia , Pólipos Intestinais/diagnóstico , Pólipos Intestinais/cirurgia , Masculino , Sangue Oculto
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