Pedunculated Brunner's gland hamartoma of the duodenum causing upper gastrointestinal hemorrhage.
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A case of pedunculated Brunner's gland hamartoma (BGH) of the duodenum causing upper gastrointestinal (GI) hemorrhage is reported. The patient was a 47-year-old man who visited our hospital for further evaluation of tarry stools and shortness of breath. Endoscopic examination of the upper digestive tract revealed a large peduncular polyp with bleeding, about 30 mm in diameter, arising from the wall of the second portion of the duodenum. GI bleeding occurred from the base of the stalk of the polyp. Endoscopic polypectomy was performed. Histological examination of the specimen revealed that the main body of the polyp contained several lobules of mature Brunner's gland with areas of cystic dilatation. The surface epithelium consisted of normal duodenal mucosa with areas of focal ulceration. This polyp was diagnosed as a BGH. The symptom of tarry stools resolved after endoscopic resection. Our case shows that treatment is necessary for duodenal BGH if GI bleeding occurs. (+info)
Pancreas sparing resection for giant hamartoma of Brunner's glands.
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CONTEXT: Benign proliferative changes of the Brunner's glands account for about 10% of neoplasias of the duodenal bulb. CASE REPORT: The authors present a case of giant hamartoma of Brunner's glands. The patient presented clinically with vague epigastric discomfort. A pancreas-sparing duodenal resection was performed. The patient made an uneventful recovery and is well at a one year follow-up. The diagnosis was established on histopathology. CONCLUSION: Duodenal hamartomas are rare and may become very large, mandating surgical removal. A pancreas-sparing duodenal resection is one of the modalities of treating such lesions. (+info)
Laparoscopic antrectomy for a proximal duodenal Brunner gland hamartoma.
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BACKGROUND: Adenoma is the most common cause of duodenal polyps, while hamartomas are very rare. We present a patient with a preoperative histology proved diagnosis of isolated duodenal tubulovillous adenomatous polyp with high-grade dysplasia for whom we performed laparoscopic antrectomy. CASE REPORT: The patient was a 56-year-old male with vague upper abdominal pain. Investigations revealed a 3-cm x 3-cm mass arising from the duodenal mucosa with no evidence of extraserosal spread. Histopathology documented an adenomatous polyp with high-grade dysplasia, so a laparoscopic antrectomy was performed. RESULTS: The patient had an uneventful postoperative period, requiring only 2 doses of parenteral analgesics. He was discharged on the seventh postoperative day. The final histopathological findings were consistent with benign hamartoma. No recurrence has been reported after 14 months of follow-up with endoscopy. DISCUSSION: Many procedures have been described for polyps, such as endoscopic excision, duodenectomy, pancreatoduodenectomy, and laparoscopic polyp excision. In our patient, the decision to perform duodenectomy was based on the preoperative findings of a sessile tubulovillous adenomatous polyp with high-grade dysplasia. Histologically, the 2 entities can be identical, especially with the small tissue volume obtained from endoscopic biopsy. CONCLUSION: Given these observations, antrectomy was probably ideal, because endoscopic excision would have been inadequate and even dangerous while pancreatoduodenectomy would have been too radical. (+info)
Surgical management of giant Brunner's gland hamartoma: case report and literature review.
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Cystic Brunner's gland hamartoma in the duodenum: a case report.
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Cystic Brunner's gland hamartoma in the duodenum is exceedingly rare, although microscopic examination may sometimes reveal a Brunner's gland hamartoma containing dilated ducts in the duodenum. We present a case of large cystic Brunner's gland hamartoma in the duodenum with a long stalk, which is described in light of multidetector-row computed tomography, magnetic resonance imaging, and a modified small bowel series, together with pathologic correlation and differential diagnosis. (+info)
Human hephaestin expression is not limited to enterocytes of the gastrointestinal tract but is also found in the antrum, the enteric nervous system, and pancreatic {beta}-cells.
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