Brunneroma: reporte de un caso / Brunneroma: a case report

Fundamento: las glándulas de Brunner son estructuras túbulo-acinares ubicadas en la submucosa del duodeno. Su crecimiento excesivo por lo regular no da síntomas o estos son mínimos, lo cual es conocido como adenoma de glándulas de Brunner, hamartoma o brunneroma. Su localización más frecuente es en la primera porción del duodeno y muy raro por debajo de la ampolla de Váter. Objetivo: presentar el caso clínico de un paciente con el diagnóstico de Brunneroma.Caso Clínico: paciente femenina, blanca de 72 años de edad con antecedentes de padecer de úlcera duodenal hace 20 años que ingresa con dolor difuso en abdomen superior acompañado de deposiciones abundantes como borra de café, sudoraciones profusas y pérdida ligera de peso en el último mes. Conclusiones: el Brunneroma es una lesión benigna poco frecuente del duodeno; puede descubrirse de forma accidental y en algunas ocasiones pueden causar hemorragia digestiva(AU)

Background: The Brunners glands are tubular structures located in the submucosa of the duodenum. Their excessive growth does not usually give symptoms or at least they are minimum. This is known as Brunners gland adenoma, Hamartoma or Brunneroma. Its most frequent localization is in the first portion of the duodenum, but it is extremely strange below the ampulla of Vater. Objective: to present the clinical case of a patient with the diagnosis of Brunneroma. Clinical case: white-skinned, 72 years-old, female patient with antecedents of a 20-years duodenal ulcer who is hospitalize with diffuse pain in superior abdomen accompanied by abundant depositions like coffee powder, profuse sweating and slight loss of weight in the last month. Conclusions: Brunneroma is a not very frequent benign lesion of the duodenum; it can be discovered accidentally and in some occasions it may cause digestive hemorrhage(AU)

Stereologic characteristics of pig small intestine during normal development.

Stereologic methods were used to study the behavior of the pig's intestinal wall during periods that are characterized by a high incidence of gastrointestinal disorders. For this purpose conventionally stained transverse and vertical paraffin sections were made of the small intestine (duodenum, jejunum, and ileum) of fetal, neonatal, and weaned pigs. The volumes of the intestinal walls were estimated using Cavalieri's method. Subsequently, the surface density (Sv) of the tunica mucosa and the volume densities (Vv) of the different small intestinal elements were estimated. Finally, the surface and volumes per serosal surface area (Ss and Vs) were calculated. The decrease of Sv can be attributed to the finding that the mucosal surface increases to a lesser extent compared with the volume of the intestinal wall. The Vs of the various layers increased postnatally, illustrating that the intestinal wall thickens. Despite an increasing total mucosal surface, this postnatal thickening causes Ss to decline. Each of these changes is temporally related to dietary changes, an increased antigen load, and an increased need for protection. Additionally, the regional differences of the various parameters match the qualitative descriptions of the small intestine of the pig and relate to region-specific functions.

Perinatal development of Brunner's glands in the rat: morphometrical study.

Perinatal changes of the Brunner's glands in rats from fetal day 20 through neonatal day 3 were studied morphometrically and electron-microscopically. Percentage volume of secretory granules of the gland cells did not change from fetal day 20 through neonatal day 1 and increased significantly from neonatal days 1-2; this level was maintained through neonatal day 3. Electron-microscopically, the gland cells during the fetal days were rich in free ribosomes. The Golgi apparatus and rough-surfaced endoplasmic reticulum (RER) were poorly developed during fetal days. After birth, however, the cells showed active formation of secretory granules, which was evidenced by well-developed Golgi apparatus, distended RER and accumulation of granules in the apical cytoplasm. Furthermore, light microscopy revealed that strongly PAS-positive material increased for the first time after birth, indicating remarkable formation of the secretory granules. Thus, the present study indicates that the cell of the Brunner's glands become active in secretory granule formation just after birth by responding to ingested material following birth.

[Effect of a diet with excess cellulose on the morphofunctional status of the duodenal glands in the rat]. / Vliianie ratsiona s izbytkom kletchatki na morfofunktsional'noe sostoianie duodenal'nykh zhelez krys.

The developmental degree of the duodenal glands and their functional activity have been studied in rats given food with an increased contents of cellulose. In 3 months in the duodenum of the test animals extent of the glandular field increases significantly in comparison to the intact animals. This increase is connected with new formation of the gland terminal parts from epithelium of the intestinal crypts in the more caudal parts of the gut. Simultaneously, functional activity of the glandular cells increases; this is evident from elevated concentration of RNA in nucleoli, share of the nucleoli with predominant contents of euchromatin, and also from decreased concentration of PAS-positive secretion in the terminal parts. These differences can be connected with changes in pH of the stomach contents towards acidic value, when excess of cellulose is taken.

[Development of the duodenal glands in rats on a high cellulose diet]. / Razvitie duodenal'nykh zhelez u krys pri povyshennom soderzhanii v ratsione kletchatki.

Wistar weaned rats were kept on cellulose-rich diet for 3 months. They revealed the duodenal gland area of increased length, as compared to the control group kept on standard pellets. Glandular-duodenal index, that is a relative indication of gland development, also rose. Cellulose-fed rats showed a lower pH of the stomach contents. The correlation between pH and gland development has been established. Possible reasons for a more intensive gland enlargement in herbivorous animals are being discussed.

Postnatal growth of Brunner's glands in the mouse.

In the newborn mouse the glands of Brunner consist of a few tubular downgrowths from the proximal duodenal crypts. Within three weeks the characteristic 'comma' shape of the gland is established by later downgrowths from more distal growths. The gland cells, although specialized from birth, show a high mitotic index, and a high labelling index with 3H-T, during the first three weeks, and particularly during the first two weeks. Nevertheless, the daily mitotic rate during this period is insufficient to account for the daily addition of glandular cells, suggesting that there is a continuing contribution of cells from the crypts. After this time, however, the mitotic activity of the mature gland cells is sufficient to account for the continuing increase in cell population. After the fourth postnatal week the mitotic and labelling indices decline markedly, and although mitoses are rarely seen in individual sections from older animals, cellular addition at a very slow rate is sufficient to account for the gradual expansion in size of the gland, and the process continues long after the adult body weight has been established.