Endoscopic resection of a huge Brunner’s gland adenoma

Abstract

Brunner's gland adenoma is a rare tumour of the duodenum, which is usually benign. A 71-year-old woman presenting with epigastric pain, upper gastrointestinal haemorrhage and melaena was reported in this paper. Upper gastro-intestinal (GI) endoscopy revealed a large pedunculated tumour on the superior part of the duodenal bulb. Endoscopic polypectomy was successfully performed by clipping and nylon thread without any complications. Histological examination revealed a Brunner's gland adenoma.

A Rare Case of Brunner’s Gland Adenoma causing Melena

“…Brunner's gland adenoma is a rare benign, proliferative lesion arising from the Brunner's gland of the duodenum and is known by various names as Brunneroma or polypoidal hamartoma. Brunner gland adenoma was first reported by Cruveilhier in 1835 [1]. We report Brunner's gland adenoma in a 50-year-old female who presented with melena and review briefly Brunner's gland adenoma's clinical presentations, radiological, pathological features and therapy.…”

“…The most common clinical presentation of Brunner's gland adenoma is either bleeding (due to ulceration or erosion of the tumor) or obstruction. Less frequent presentations include obstructive jaundice, intussusception, recurrent pancreatitis or diarrhea (owing to duodenal motor disturbance) [1,[7][8][9][10].…”

“…Symptomatic Brunner's gland adenoma (like in our case) need surgical resection. When the tumour is small or pedunculated, endoscopic polypectomy is the first choice [1,13]. Open surgical excision is reserved for cases where snaring has failed or when tumour is very large [14,15].…”

Multi-scale elastoplastic mechanical model and microstructure damage analysis of solid expandable tubular*

“…The wide application of the SET technology can greatly reduce the drilling cost and shorten the work period. [3,4] At present, the most critical technical problem of the SET is the selection of materials with large expansion ratios. Due to the lack of research and development and the unclear mechanical expansion mechanism of the SET with a large expansion ratio, there is no theoretical basis for the reasonable design and material selection of the SET.…”