Successful Endoscopic Resection of Large Pedunculated Brunner's Gland Hamartoma Causing Gastrointestinal Bleeding Arising from the Pylorus

Brunner’s gland hamartomas are rare, benign small bowel tumours. There were fewer than 150 cases reported in the English literature until the end of the last century. These hamartomas may be discovered incidentally during an upper gastrointestinal tract endoscopy. Otherwise, they may be diagnosed in patients presenting with acute upper gastrointestinal bleeding, anemia or symptoms of intestinal obstruction. The case of a young woman admitted for acute upper gastrointestinal bleeding along with acute pancreatitis is presented. The investigation revealed a giant Brunner’s gland hamartoma in the second part of the duodenum. After total endoscopic resection of the tumour, the patient has remained completely asymptomatic for a follow-up period of seven months.

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A Rare Cause of Upper Gastrointestinal Bleeding: Brunner’s Gland Hamartoma

Medical Bulletin of Haseki ◽

10.4274/haseki.72692 ◽

2018 ◽

Vol 56 (2) ◽

pp. 158-161

Author(s):

Mehmet Uluşahin ◽

Etem Alhan ◽

Mehmet Arif Usta

Keyword(s):

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Brunner’S Gland ◽

Brunner's Gland ◽

Brunner’S Gland Hamartoma ◽

Upper Gastrointestinal

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En Bloc Endoscopic Resection of Large Pedunculated Brunner’s Gland Hamartoma: A Case Report

Case Reports in Gastroenterology ◽

10.1159/000490098 ◽

2018 ◽

Vol 12 (2) ◽

pp. 344-351

Author(s):

Annalisa Pasetti ◽

Elvira Capoferro ◽

Giulia Querzoli ◽

Renzo Montanari ◽

Paolo Bocus

Keyword(s):

Endoscopic Resection ◽

Epigastric Pain ◽

Duodenal Bulb ◽

Anterior Wall ◽

Upper Gastrointestinal Endoscopy ◽

En Bloc ◽

Brunner’S Gland ◽

Brunner's Gland ◽

Brunner’S Gland Hamartoma ◽

Submucosal Lesion

Brunner’s gland hamartoma (BGH) is an uncommon benign tumor arising from alkaline-based mucin-secreting glands of the duodenum. These lesions are typically discovered incidentally during upper gastrointestinal endoscopy or radiological diagnostics, even though they can eventually lead (in the case of increasing size) to obstructive or hemorrhagic symptoms. We report the case of a 67-year-old Caucasian man with two episodes of melena and epigastric pain during the last month. Esophagogastroduodenoscopy revealed a large pedunculated and eroded polyp inside the antrum with a 2-cm-long stalk arising from the anterior wall of the duodenal bulb. Endoscopic ultrasonography showed a submucosal lesion with homogeneous hyperechoic parietal thickening and some central gaps. The muscularis was undamaged. No lymphadenopathy was observed. We performed an en bloc endoscopic resection of the polyp. The size of the whole piece was approximately 6 × 3 × 2 cm, pseudocapsulated and tough in consistency. In the case presented, the en bloc endoscopic removal was successful despite the size of the tumor.

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Brunner’s Gland Hamartoma: A Rare Cause of Gastrointestinal Bleeding – Case Report and Review of the Literature

Canadian Journal of Gastroenterology ◽

10.1155/2002/797934 ◽

2002 ◽

Vol 16 (5) ◽

pp. 309-313 ◽

Cited By ~ 16

Author(s):

David R Stolpman ◽

Gordon C Hunt ◽

Brett Sheppard ◽

Hahn Huang ◽

Deepak V Gopal

Keyword(s):

Gastrointestinal Bleeding ◽

Endoscopic Ultrasound ◽

Deficiency Anemia ◽

Normal Range ◽

Ferritin Concentration ◽

The Third ◽

Brunner’S Gland ◽

Brunner's Gland ◽

Brunner’S Gland Hamartoma ◽

Upper Gastrointestinal

An unusual cause of upper gastrointestinal bleeding is described in a previously healthy 45-year-old man who was admitted to hospital with weakness and fatigue, and had experienced an episode of melena two days before admission. His medical and surgical history was unremarkable. Upon admission to hospital, he showed evidence of iron-deficiency anemia, with a hemoglobin concentration of 61 g/L (normal range 135 to 175 g/L), a mean corpuscular volume of 73 fL (normal range 85.0 to 95.0 fL) and a ferritin concentration of 1.0 µg/L (normal range in males 15 to 400 µg/L). Upper gastrointestinal endoscopy revealed a 3.5 cm ulcerated submucosal mass in the third portion of the duodenum, for which mucosal biopsies were nondiagnostic. A subsequent endoscopic ultrasound revealed a 2.7×4.0 cm hyperechoic, cystic, submucosal tumour in the third portion of the duodenum. Endoscopic ultrasound-guided fine needle aspiration revealed no malignant cells. The patient eventually underwent a resection of the third portion of his duodenum. Surgical pathology revealed that this tumour was a Brunner’s gland hamartoma, 4.5 cm in its greatest dimension.

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