Rey P, Mambrini P, Barthet M, Orsoni P, Larroque O, Salducci J, Picaud R, Grimaud J C
Service d'Hépato-Gastroentérologie, Hôpital d'Instruction des Armées A. Laveran, Marseille Armées.
J Chir (Paris). 1996 Jun;133(4):162-6.
Pseudo-tumoral hyperplasia of the Brünner glands is an exceptional dysembryoplastic or hyperplastic lesion which develops in the submucosa of the supra papillary proximal duodenum. We report a case of Brünner adenoma which led to duodenal obstruction. In 50% of the cases, the adenoma was asymptomatic but non-specific signs may lead to barium studies. CT scan of the abdomen or esogastroduodenal endoscopy which rarely provides formal histological proof. Major complications (hemorrhage, duodenal obstruction) and lack of formal diagnosis often leads to surgery, ideally with tumor resection after duodenotomy. Other prodecures (simple observation, endoscopic polypectomy, duodenopancreatectomy, biliary or digestive bypass without tumorectomy) may be entertained depending on the functional status, the volume of the tumor, presence of complications and overall general status.
布伦纳腺假肿瘤样增生是一种罕见的胚胎发育异常或增生性病变,发生于十二指肠乳头近端黏膜下层。我们报告一例导致十二指肠梗阻的布伦纳腺瘤病例。50%的病例中,腺瘤无症状,但非特异性体征可能导致钡剂造影检查。腹部CT扫描或食管胃十二指肠内镜检查很少能提供确切的组织学证据。主要并发症(出血、十二指肠梗阻)以及缺乏确切诊断常导致手术治疗,理想情况下是在十二指肠切开术后切除肿瘤。根据功能状态、肿瘤大小、有无并发症及总体一般状况,也可考虑其他治疗方法(单纯观察、内镜下息肉切除术、十二指肠胰腺切除术、未切除肿瘤的胆肠或消化旁路手术)。