Sulz M C, Thurnheer M, Meyenberger C
Department of Medicine, Division of Gastroenterology and Hepatology, Hospital of St. Gallen, St. Gallen, Switzerland.
Case Rep Gastroenterol. 2009 Aug 28;3(2):260-264. doi: 10.1159/000235236.
Brunneroma is a rare, benign, proliferative lesion arising from the Brunner's glands of the duodenum that exceptionally may evolve towards a malignant transformation, usually discovered incidentally at endoscopy. Occasionally, these lesions manifest as a rare cause of duodenal obstruction or upper gastrointestinal bleeding and require resection, usually for tumors larger than 4 cm. The special aspect of our case is the technically difficult but successful dual transoral endoscopic resection of a giant (6.5 × 4 × 2.4 cm) brunneroma with a very thick and long peduncle located extremely close to the pylorus, highlighting the possibilities of endosurgery. Distal stomach resection with Roux-en-Y reconstruction as an alternative would have caused higher morbidity and costs.
布伦纳腺瘤是一种罕见的、良性的、增生性病变，起源于十二指肠的布伦纳腺，极少数情况下可能会发生恶性转化，通常在内镜检查时偶然发现。偶尔，这些病变表现为十二指肠梗阻或上消化道出血的罕见原因，通常对于直径大于4厘米的肿瘤需要进行切除。我们病例的特殊之处在于，对一个巨大的（6.5×4×2.4厘米）布伦纳腺瘤进行了技术上困难但成功的经口双内镜切除，该腺瘤有非常粗且长的蒂，位置极其靠近幽门，突出了内镜手术的可能性。作为替代方案的远端胃切除并 Roux-en-Y 重建会导致更高的发病率和费用。
