Gastric outlet obstruction caused by Brunner's gland hyperplasia: case report and review of literature

Krishnamurthy, Padmini; Junaid, Omar; Moezzi, Jazbieh; Gopalswamy, N.

doi:10.1016/j.gie.2006.02.026

Cited by 26 publications

(27 citation statements)

References 20 publications

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“…Most of the lesions are less than 1 cm in size and asymptomatic. Occasionally, it causes symptoms of obstruction and abdominal pain [6,7]. Endoscopy has a sensitivity of 72-89%, however biopsies may be non-diagnostic as lesions are submucosal and may be missed on pinch biopsy which is one of the possibilities occurred in our case.…”

Section: Discussionmentioning

confidence: 73%

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Gastric Outlet Obstruction Caused by a Triple Lesion: Eosinophilic Gastroenteritis, Brunner’s Gland Hyperplasia and Pancreatic Heterotopia in Unison

Sharma¹

2017

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Abstract:Gastric outlet obstruction is a common entity described with numerous benign and malignant causes. Historically, benign causes include Peptic Ulcer disease (PUD); however recent cases have reported other causes including Eosinophilic Gastroenteritis (EGE), Brunner's Gland Hyperplasia (BGH) and Pancreatic Heterotopia (PH). We present an unusual case of a 31 year old male patient with severe gastric outlet obstruction requiring surgical intervention caused by all three pathologies in unison -EGE, BGH and PH. The patient underwent surgical resection with distal gastrectomy and Billroth II reconstruction. Histology confirmed the three pathologies and post-operative recovery of the patient was uneventful.

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Section: Discussionmentioning

confidence: 73%

“…BGH is a benign lesion that is mostly asymptomatic. However, occasionally they can attain larger sizes and cause symptoms of obstruction [5,6]. PH is a rare condition which is generally asymptomatic, but may present as a cause of GOO [8,9].…”

Section: Introductionmentioning

confidence: 99%

Gastric Outlet Obstruction Caused by a Triple Lesion: Eosinophilic Gastroenteritis, Brunner’s Gland Hyperplasia and Pancreatic Heterotopia in Unison

Sharma¹

2017

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“…Nevertheless, the condition may cause epigastric pain, obstruction, diarrhea, gastrointestinal hemorrhage, obstructive jaundice, and pancreatitis depending on the size, type and location of BGH (1,4,8). Duodenal obstruction in BGH is caused mostly by a polyp or hamartoma, while circumferential hyperplasia is rare (2). Our patient presented with severe vomiting and had a rare case of duodenal obstruction caused by circumferential BGH without any mass.…”

mentioning

confidence: 75%

“…These tubuloalveolar glands extend from the pylorus to the second portion of the duodenum and secrete pepsinogen, urogastrone and mucus in response to the acid in the duodenum (1)(2)(3). BGH mostly presents during the 5 th and 6 th decades and is quite rare in the pediatric age group.…”

mentioning

confidence: 99%

Diffuse circumferential hyperplasia of Brunner's glands causing obstruction in the duodenum in a 12-year-old child

Kirmemiş¹,

Çaltepe²,

Süllü³

et al. 2012

Turk J Gastroenterol

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Brunner's glands consist of submucosal mucinsecreting glands, which are located in the duodenum (1). Brunner's gland hyperplasia (BGH) is usually asymptomatic. A few cases causing obstruction, hemorrhage or intussusceptions in adults have been reported in the literature (2). We report a case of a 12-year-old boy with BGH presented with duodenal obstruction.A 12-year-old boy was admitted to our emergency department with significant vomiting and weight loss over the course of one week. On the present admission, physical examination revealed extensive abdominal tenderness, especially in the epigastric region. An upper endoscopy showed mild esophagitis, completely open pylorus and considerably widened bulb. The mucosa seen in the intersection between the first and second part of the duodenum was edematous and hyperemic, and the instrument did not pass through at that level because of severe narrowing (Figure 1). Barium examination of the upper gastrointestinal tract revealed that the stomach and the first part of the duodenum were distended, passage through the second part of the duodenum was delayed, and retrograde filling of the stomach was observed. Histological examination revealed BGH. Lobules of Brunner's glands were extended into the lamina propria and were separated by delicate fibrous septa ( Figure 2). The cells constituting the glands were cytologically bland and showed no mitotic activity. An antral biopsy specimen was negative for Helicobacter pylori, and serum gastrin level was within normal limits. An abdominal computed tomography was performed, which showed an enlarged stomach and bulb, but no masses were detected. According to the subsequent assessment made together with pediatric surgery and radiology, the patient un-

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“…The soft and submucosal appearance and the rupture or flattening of the lesions following endoscopic biopsies may aid in diagnosing Brunner's gland cyst. However, a final diagnosis of Brunner's gland cyst is based on pathological findings of resected lesions obtained by endoscopic mucosal resection, polypectomy or surgical treatment (10,36). Pathologically, Brunner's gland cysts are typically confined to the submucosa and consist of a single layer of connective tissue and epithelial cells, which are composed of columnar cells containing basal round nuclei and granular cytoplasm (37).…”

Section: Case Reportmentioning

confidence: 99%

Brunner's gland cyst in combination with gastrointestinal stromal tumor: A case report

et al. 2016

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Abstract. Brunner's gland cysts are rare benign lesions that are mainly observed in the first and the second regions of the duodenum. Patients with Brunner's gland cyst demonstrate no specific symptoms. The present study reports the case of a patient with Brunner's gland cyst located in the duodenum in combination with a gastrointestinal stromal tumor (GIST) in the same region. To the best of our knowledge, the present study reports the first case of Brunner's gland cyst with GIST. A 58-year-old female patient was referred to Tianchang Hospital of Traditional Chinese Medicine (Tianchang, China) with a one-month history of upper abdominal discomfort, diarrhea and recurrent vomiting following the intake of food. Upper gastrointestinal endoscopy and a computed tomography scan revealed the presence of a round, cystic-like lesion with internal low density located within the duodenum. Pathological examination revealed that the cyst measured 0.3 cm in diameter and was consistent with a diagnosis of Brunner's gland cyst. Histopathology revealed that the cyst possessed characteristics of GIST. The patient underwent surgical exploration and tumor resection, and was discharged 2 weeks post-surgery. During the 12 month post-operative follow-up period, the outcome of the patient was good. This case study of Brunner's gland cyst combined with GIST enriches the present literature and promotes better understanding of the two diseases. Further investigation is required to explain the mechanism and association between the two rare diseases.

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Gastric outlet obstruction caused by Brunner's gland hyperplasia: case report and review of literature

Cited by 26 publications

References 20 publications

Gastric Outlet Obstruction Caused by a Triple Lesion: Eosinophilic Gastroenteritis, Brunner’s Gland Hyperplasia and Pancreatic Heterotopia in Unison

Gastric Outlet Obstruction Caused by a Triple Lesion: Eosinophilic Gastroenteritis, Brunner’s Gland Hyperplasia and Pancreatic Heterotopia in Unison

Diffuse circumferential hyperplasia of Brunner's glands causing obstruction in the duodenum in a 12-year-old child

Brunner's gland cyst in combination with gastrointestinal stromal tumor: A case report

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