Bakir Mohammed A, AlYousef Mohammed Y, Alsohaibani Fahad I, Alsaad Khaled O
College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
College of Medicine, King Saud University, Riyadh, Saudi Arabia.
J Surg Case Rep. 2020 Aug 26;2020(8):rjaa191. doi: 10.1093/jscr/rjaa191. eCollection 2020 Aug.
Proliferative lesions of the Brunner's glands are uncommonly encountered lesions of the small intestine, originating from the deeply seated mucosal and submucosal Brunner's glands, mainly in the duodenum. The vast majorities of these lesions are benign and include Brunner's glands hyperplasia (adenomas/nodules) and hamartomas. The etiology and pathogenesis of these lesions are not fully understood, and the diagnosis can sometimes be challenging. We report a case of Brunner's gland hamartoma in a 57-year-old man who presented with chronic dyspepsia, hematemesis and weight loss. Endoscopic and radiological investigations show a submucosal polypoid lesion at the first part of the duodenum. Routine endoscopic biopsies demonstrated normal duodenal mucosa. The lesion considered endoscopically unresectable and was surgically resected. Frozen section examination and intraoperative consultation showed unremarkable duodenal mucosa and histologically bland Brunner's glands.
布伦纳腺增生性病变是小肠罕见的病变，起源于深部的黏膜和黏膜下布伦纳腺，主要位于十二指肠。这些病变绝大多数是良性的，包括布伦纳腺增生（腺瘤/结节）和错构瘤。这些病变的病因和发病机制尚未完全明确，诊断有时具有挑战性。我们报告一例57岁男性布伦纳腺错构瘤病例，该患者表现为慢性消化不良、呕血和体重减轻。内镜和影像学检查显示十二指肠第一部有一个黏膜下息肉样病变。常规内镜活检显示十二指肠黏膜正常。该病变经内镜检查认为无法切除，遂行手术切除。冰冻切片检查和术中会诊显示十二指肠黏膜无异常，布伦纳腺组织学表现平淡。
