A Case Of Huge Brunner's Gland Adenoma With Acute Bleeding Treated By Endoscopic Resection

Article information

Kosin Med J. 2015;30(2):171-174
Publication date (electronic) : 2015 January 20
doi : https://doi.org/10.7180/kmj.2015.30.2.171
1Department of Internal Medicine, Anyang-si, Gyeonggi-do, Korea.
2Department of Pathology, Anyang SAM hospital, Anyang-si, Gyeonggi-do, Korea.
Corresponding Author: Seungchul Suh, M.D. Department of Internal medicine, Anyang SAM hospital, 9, Samdeok-ro, Manan-gu, Anyang-si, Gyeonggi-do 14030, Korea Tel: +82-31-467-9110, Fax:+82-31-467-9198, E-mail: orient4@naver.com
Received 2014 November 05; 2015 January 30; Accepted 2015 February 24.

Abstract

Abstract

Brunner's gland adenoma is a rare benign small bowel neoplasm and it represents 10% of small bowel benign tumor. Most of adenoma manifest as polypoidal, multiple and size does not exceed 1 cm and mostly asymptomatic, but the lesion larger than 1 ㎝ is solitary and can cause bleeding, obstruction, intussusception and there are some reports of showing malignant transformation. Until the present, there are two cases of over 8㎝ huge Brunner's gland adenoma in Korea and each of their chief complaint was abdominal discomfort and melena, but there is no case report of over 8 ㎝ Brunner's gland adenoma accompanied with acute bleeding as seen in this case. We diagnosed an 8 ㎝ sized, huge duodenal Brunner's gland adenoma which accompanied with acute bleeding and treated it by endoscopic resection using an IT-knife, successfully.

Fig. 1.

Endoscopic finding. It shows a huge pedunculated polyp with bleeding arising from the bulb.

Fig. 2.

Endoscopic finding. It shows a cross-section of the resected stalk using an IT knife

Fig. 3.

Gross finding. The polyp is about 80mm long and 35mm wide.

Fig. 4.

Histological finding. The polyp consists of glands, dilated cystic ducts, adipose tissue and lymphoid cells revealing as hamartoma.(H&E staining, x 100)

References

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Article information Continued

Fig. 1.

Endoscopic finding. It shows a huge pedunculated polyp with bleeding arising from the bulb.

Fig. 2.

Endoscopic finding. It shows a cross-section of the resected stalk using an IT knife

Fig. 3.

Gross finding. The polyp is about 80mm long and 35mm wide.

Fig. 4.

Histological finding. The polyp consists of glands, dilated cystic ducts, adipose tissue and lymphoid cells revealing as hamartoma.(H&E staining, x 100)