A Case of Giant Brunner's Gland Hyperplasia in the Duodenum resected by Incising the Gastric Wall

Kuniyuki Gomi, Shoji Kajikawa, Kazutaka Nishiyama, Kou Shimada, Kazuyuki Yazawa, Hiroshi Shirota and Tomotsugu Nakamura*

Department of Surgery and Department of Pathology*, Suwa Red Cross Hospital

A 55-year-old woman was found in esophagogastro duodenoscopy to have a large duodenal tumor in the duodenal bulb with a stem extending to the descending duodenum with a submucosal tumor-like appearance. Suspecting Brunner's gland adenoma based on endscopic ultrasonography, we considered resection to avoid bleeding and strangulation and potential of malignancy, but could not observe the entire tumor and felt endoscopic polypectomy to be risky. We conducted resection by with laparotomy, finding Brunner's gland hyperplasia involved in pathological diagnosis. The tumor was 6.5 cmlong. Reports of resection by endoscopic polypectomy for Brunner's gland adenoma have increased in number, but in the cases of huge tumors such as in this case, it is safer to conduct resection by laparotomy if the gastric wall can be incised.

Key words
Brunner's gland hyperplasia, duodenal tumor, operation

Reprint requests
Kuniyuki Gomi Department of Surgery, Suwa Red Cross Hospital
5-11-50 Kogandouri, Suwa, 392-8510 Japan

Accepted
March 25, 2009

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