Giant duodenal polyp

A 52 year-old man was referred with a history of anemia and fatigue. There was no melena and he was not taking any medication Blood analysis revealed microcytic anemia, with a hemoglobin of 9,7 g/dl (NR 13-18 ), MCV of 65,8 fl (NR 80-100) and serum ferritine was below 5 ng/ml (NR 30-400) with normal coagulation.There was no inflammation, no renal insufficiency and liver function tests were normal. Vitamine B12 and folic acid were normal. He underwent endoscopic work-up. Colonoscopy was normal. Gastroscopy revealed a large pedunculated polyp (5x2 cm) localized in the duodenal bulb and it was eroded on the top (Figure 1A and B). Multiple biopsies were taken showing no abnomarlity. There was no Helicobacter pylori nor metaplasia.

A CASE OF BRUNNERS GLAND HAMARTOMA CAUSING OBSTRUCTIVE JAUNDICE

Brunner’s gland hamartoma is a rare benign tumor of duodenum .We present a case of large pedunculated duodenal hamartoma causing obstructive jaundice and significant dilatation of intrahepatic biliary radicles. Duodenal polyp is a rare benign tumor formed from a proliferation of Brunner gland, typically forming polypoid growth in proximal duodenum and can extend up to 3rd part of duodenum. It may be incidental finding but can present in emergency with obstruction and hemorrhage requiring surgical endoscopic resection.