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Case Report
Giant Brunner’s Gland Hamartoma of the Duodenal Bulb Presenting with Upper Gastrointestinal Bleeding and Obstruction
Ju Hyoung Lee, Kyeong Min Jo, Tae Oh Kim, Jong Ha Park, Seung Hyun Park, Jae Won Jung, So Chong Hur, Sung Yeun Yang
Clin Endosc 2016;49(6):570-574.   Published online October 13, 2016
DOI: https://doi.org/10.5946/ce.2016.022
AbstractAbstract PDFPubReaderePub
Brunner’s gland hamartomas are small benign lesions that are most commonly found in the bulb of the duodenum. They are very uncommon, and most are found incidentally during upper gastrointestinal series or esophagogastroduodenoscopy. The lesions tend to be asymptomatic, but patients may present with symptoms of duodenal obstruction or hemorrhage secondary to ulceration. Histologically, a Brunner's gland hamartoma consists of the components of Brunner's gland cells, as well as glandular, adipose and muscle cells. In this study, we report the case of a 30-year-old man who presented with upper gastrointestinal bleeding and obstructive symptoms due to a giant Brunner's gland hamartoma in the duodenal bulb. The hamartoma was successfully removed by endoscopic resection. No significant complications were observed. Microscopically, the lesion was found to be entirely composed of variable Brunner's glands and adipocytes.

Citations

Citations to this article as recorded by  
  • Brunner’s gland hamartomas: Not always benign
    Manar Shmais, Ahmad Mousawi, Fadi Mourad, Ala I. Sharara
    Arab Journal of Gastroenterology.2024; 25(1): 70.     CrossRef
  • The Characteristics and Treatment Outcomes of 71 Duodenal Brunner’s Gland Adenomas with Endoscopic Submucosal Dissection
    Ying Xiang, Jinyan Liu, Nan ya Wang, Dehua Tang, Lei Wang, Ping xiao Zou, Guifang Xu, Qin Huang
    Digestive Diseases.2023; 41(6): 852.     CrossRef
  • Giant brunner gland hamartoma: An unusual cause of upper gastrointestinal bleed
    Bershic Valantine, ManjunathB Venkatapur, Sultan Nawahirsha, SBabu Kumar
    Gastroenterology, Hepatology and Endoscopy Practice.2023; 3(3): 90.     CrossRef
  • A giant Brunner’s gland hamartoma being treated as a pedunculated polyp: a case report
    Lizhi Yi, Zhengyu Cheng, Huarong Qiu, Jianjun Yang, Tao Wang, Ke Liu
    BMC Gastroenterology.2019;[Epub]     CrossRef
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Efficacy of Niti-S ComVi Stents for Palliation of Malignant Gastrointestinal Obstruction
Seong Eun Kim, M.D., Jeong Seop Moon, M.D., Jin Kwang Lee, M.D., Jin Gook Huh, M.D., Jong Sung Lee, M.D., Tae Yeob Jeong, M.D., Soo Hyung Ryu, M.D., Jung Whan Lee, M.D. and You Sun Kim, M.D.
Korean J Gastrointest Endosc 2007;34(4):185-192.   Published online April 30, 2007
AbstractAbstract PDF
Background
/Aims: Niti-S ComVi stents are flexible and retain the shape-memory of the original configuration. ComVi stents are effective in preventing tumor ingrowth because polytetrafluoroethylene is inserted between two stent wires. The aim of this study was to examine the efficacy of Niti-S ComVi stents for the palliation of a malignant gastrointestinal obstruction. Methods: Between April 2004 and April 2006, 17 patients (20 cases) underwent Niti-S ComVi stenting, using a through-the- scope method. The technical and clinical success, complication, and outcome were analyzed. Results: Stent insertion was technically successful in 18 cases (90%). Malposition to the afferent loop occurred in 2 cases. Symptomatic improvement was achieved in 14 cases (70%). The mean gastric outlet obstruction score was 0.2 before stenting and 1.6 after stenting. The complications encountered were stent migration (2 cases) and obstruction (5 cases), which were treated by re-stenting and balloon dilatation. Twelve patients died with a median survival of 67 days. Five patients were still alive with a median follow up of 151 days. The overall median stent patency time was 60 days. The mean waist diameter of the stents was expanded to 57% of full expansion immediately after deployment, and 77% after 36 hours. Conclusions: Niti-S ComVi stenting is an effective palliative technique for inoperable or postoperative recurrent tumors, and significantly improves the quality of life. (Korean J Gastrointest Endosc 2007; 34:185⁣192)
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A Case of Superior Mesenteric Artery Syndrome Treated by Laparoscopic Surgery
Ji-Sung Chun, M.D., Woo-Chul Chung, M.D., Seong-Su Hwang, M.D.*, Hyun-Min Cho, M.D., Kang-Moon Lee, M.D., Bo-In Lee, M.D., Su-Yeon Lee, M.D., Ji-Won An, M.D., U-Im Chang, M.D., Jin-Mo Yang, M.D., Kyu-Yong Choi, M.D. and In-Sik Chung, M.D.
Korean J Gastrointest Endosc 2006;32(3):215-220.   Published online March 30, 2006
AbstractAbstract PDF
Superior mesenteric artery (SMA) syndrome is a symptom complex resulting from compression of third portion of duodenum by the root of the small bowel mesentery at the level of the SMA. This syndrome can occur as an acute illness but more commonly it appears as chronic condition. Identification of this syndrome can be a diagnostic dilemma and it is frequently made by exclusion. In our patient, rapid weight loss, nausea and bile stained vomiting were present. Ultrasound and MR-angiography were performed for measuring the angle and the distance between the SMA and the aorta. We confirmed the diagnosis via the reduced aorto-mesenteric angle and distance and the patient was then treated by laparoscopic surgery. After lysis of the ligament of Treitz, the patient's symptom were improved. This syndrome must be considered as one of the causes of upper gastrointestinal obstruction. (Korean J Gastrointest Endosc 2006;32:215⁣220)
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Effectiveness of Through-the-scope Self-expandable Metal Stent in Malignant Upper Gastrointestinal Obstruction
Eun Soon Kim, M.D.*, Jeong Seop Moon, M.D., You Sun Kim, M.D., Il Kim, M.D., Jin Kwang Lee, M.D., Seong Eun Kim, M.D., Soo Hyung Ryu, M.D. and Jung Whan Lee, M.D.
Korean J Gastrointest Endosc 2005;31(1):1-9.   Published online July 30, 2005
AbstractAbstract PDF
Background
/Aims: Self-expandable metal stents (SEMS) have been used in the palliation of malignant obstruction. The purpose of this study was to evaluate the effectiveness, safety, and outcome of SEMS using through-the- scope (TTS) method in the patients with malignant upper gastrointestinal obstruction including recurrent gastric cancer after gastrectomy. Methods: Thirty one patients (36 stents) were treated with SEMS between October 2000 and June 2004; nineteen had inoperable malignant gastric outlet obstruction, ten had recurrent gastric cancer after gastrectomy, and two had metastatic duodenal cancer. We analyzed the technical and clinical success, complication, and outcome. Results: The technical success rate was 88.8% (32/36 stents) in total cases; 95.0% (19/20) in malignant gastric outlet obstruction, 84.6% (11/13) in recurrent gastric cancer after gastrectomy, and 66.7% (2/3) in metastatic duodenal cancer. The success rate of dietary intake was 86.1% (31/36 stents). Complications occurred in 7 of 36 stents (19.4%), including stent migration (1 patient), aspiration pneumonia (1 patient), and recurrent obstruction (5 patients). The mean survival duration period was 118.1⁑180.2 days and mean patency period was 92.2⁑89.9 days. Conclusions: SEMS using TTS is an effective, safe, and less invasive palliative treatment in malignant upper gastrointestinal obstruction including recurrent gastric cancer after surgery. (Korean J Gastrointest Endosc 2005;31:1⁣9)
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