Pedunculated Brunner&rsquo;s gland hamartoma of the duodenum causing upper gastrointestinal hemorrhage

doi:10.3748/wjg.15.373

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Jan 21, 2009 (publication date) through Nov 30, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Jan 21, 2009; 15(3): 373-375
Published online Jan 21, 2009. doi: 10.3748/wjg.15.373

Pedunculated Brunner’s gland hamartoma of the duodenum causing upper gastrointestinal hemorrhage

Shoji Hirasaki, Motoharu Kubo, Atsushi Inoue, Yasuyuki Miyake, Hisako Oshiro

Shoji Hirasaki, Motoharu Kubo, Atsushi Inoue, Yasuyuki Miyake, Hisako Oshiro, Department of Internal Medicine, Kubo Hospital, Imabari 7992116, Japan

Author contributions: Hirasaki S and Kubo M contributed equally to this work; Hirasaki S, Kubo M, Inoue A, Miyake Y and Oshiro H were involved in the care of the patient; Kubo M performed the endoscopic resection; Hirasaki S wrote the paper.

Correspondence to: Shoji Hirasaki, Department of Internal Medicine, Kubo Hospital, 1-1-19 Uchibori, Imabari 7992116, Japan. hirasaki@icknet.ne.jp

Telephone: +81-898-413233

Fax: +81-898-415841

Received: November 25, 2008
Revised: December 15, 2008
Accepted: December 22, 2008
Published online: January 21, 2009

Abstract

A case of pedunculated Brunner’s gland hamartoma (BGH) of the duodenum causing upper gastrointestinal (GI) hemorrhage is reported. The patient was a 47-year-old man who visited our hospital for further evaluation of tarry stools and shortness of breath. Endoscopic examination of the upper digestive tract revealed a large peduncular polyp with bleeding, about 30 mm in diameter, arising from the wall of the second portion of the duodenum. GI bleeding occurred from the base of the stalk of the polyp. Endoscopic polypectomy was performed. Histological examination of the specimen revealed that the main body of the polyp contained several lobules of mature Brunner’s gland with areas of cystic dilatation. The surface epithelium consisted of normal duodenal mucosa with areas of focal ulceration. This polyp was diagnosed as a BGH. The symptom of tarry stools resolved after endoscopic resection. Our case shows that treatment is necessary for duodenal BGH if GI bleeding occurs.

Keywords: Brunner’s gland; Hyperplasia; Duodenal polyp; Endoscopic polypectomy; Gastrointestinal bleeding