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BULBUS BRUNNER GLAND HYPERPLASİA AND BRUNNER’S GLAND ADENOMA: PRESENTATİON OF 2 CASES


SH. OLMEZ, U. AVCIOGLU, S. SAYAR, A. YILDIZ SAVASH, E. OZASLAN,

E. ALTIPARMAK


Ankara Numune Education and Research Hospital
, Ankara, TURKEY

 

Introductıon: Benign lesions in duodenum are rarely observed in the process of endoscopy. Brunner gland hyperplasia is generally small and asemptomatic lesions. These lesions may cause bleeding, obstruction and rarely the development of intussusception, obstructive jaundice, diarrhea and biliary fistula. Its etiology is not clearly known. Establishing a diagnosis with endoscopic biopsy is not always possible (sensitivite %72-89). Total excision of mass must be provided. They are generally classified as diffuse nodular hyperplasia, local nodular hyperplasia and adenoma. Less than 200 cases have been reported so far. They are generally singular polypoid lesions mostly 4 cm in diameter.

Case: A 83 year-old female patient sought medical assistance with stomach pain and distention complaints. Physical examination, complete blood count and serum biochemical analysis were normal. In the upper gastrointestinal system endoscopy, a pedunculated polyp 3.5 cm in diameter was detected in the front wall of bulbus near apex and was excised by snare. Polyp pathology was reported as Brunner gland hyperplasia. Case 2: A 56 year-old male patient sought medical assistance with stomach pain, distention and pyrosis complaints. Physical examination, complete blood count and serum biochemical analysis were normal. In the upper gastrointestinal system endoscopy, a pedunculated polyp 2 cm in diameter was detected in bulbus near the apical region. The polyp was excised by snare after the clip application. Polyp pathology was reported as Brunner gland adenoma.

Conclusıon: Brunner gland hyperplasia and adenoma are rarely seen lesions. Although the treatment of asymptomatic lesions are debatable, the legions very rarely regress with medical treatments such as antacid, H2 receptor blockers and proton pump inhibitors. Moreover, it is more appropriate to remove these lesions so as to prevent complications and because it has been reported that Brunner gland adenoma cases might have malign transformation, although this is very rare. Removal by endoscopy is preferred to surgery as it is more cost-effective, less invasive and has a less complication rate.

 


Date: 2014-12-28; view: 805


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