Brunner's gland adenema [brunneroma]; an infrequent cause of upper gastrointesinal tract bleeding

ABSTRACT

The aim of this study is to characterize the clinical presentation, endoscopic pictures and pathological features of a series of patients with Brunner's gland adenomas. 7 patients out of 508 patients subjected to upper gastrointestinal endoscopy and duodenal biopsy for various gastrointestinal symptoms had underlying Brunner's gland adenomas. The patients [3 men and 4 women] presented in their 6th and 7th decades of life, with hematemesis [3 patients], melena [4 patients] or symptoms of intestinal obstruction [2 patients]. 2 patients presented with acute gastrointestinal bleeding and the remaining 5 patients presented with symptoms of more than 2 months. The majority of patients had blood hemoglobin level of less than 11 gm/dl and 3 patients required blood transfusion. Endoscopically, the lesion appeared as a polyp with a diameter ranged from 0.5 to 5 cm, covered by intact duodenal mucosa in the majority of cases. The first part of the duodenum was the site of predilection in 5 [71.5%] patients Histologically, the lesion appeared as submucosal circumscribed lobulated proliferation of Brunner's glands. Surgical excision of the tumor in 4 patients achieved complete cure