Cargando…

Massive Upper Gastrointestinal Hemorrhage in Brunner’s Gland Hamartoma of Duodenum

Brunner's gland hamartoma (BGH) is a rare benign small bowel tumor, mostly encountered in the duodenum. Massive upper gastrointestinal (UGI) hemorrhage is an unusual presentation rarely reported in English literature. Symptomatic patients mostly present with features of gastric outlet obstructi...

Descripción completa

Detalles Bibliográficos
Autores principales: Dhali, Arkadeep, Ray, Sukanta, Ghosh, Ranajoy, Sarkar, Avik, Dhali, Gopal Krishna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312786/
https://www.ncbi.nlm.nih.gov/pubmed/34336406
http://dx.doi.org/10.7759/cureus.15875
_version_ 1783729199727509504
author Dhali, Arkadeep
Ray, Sukanta
Ghosh, Ranajoy
Sarkar, Avik
Dhali, Gopal Krishna
author_facet Dhali, Arkadeep
Ray, Sukanta
Ghosh, Ranajoy
Sarkar, Avik
Dhali, Gopal Krishna
author_sort Dhali, Arkadeep
collection PubMed
description Brunner's gland hamartoma (BGH) is a rare benign small bowel tumor, mostly encountered in the duodenum. Massive upper gastrointestinal (UGI) hemorrhage is an unusual presentation rarely reported in English literature. Symptomatic patients mostly present with features of gastric outlet obstruction, occult bleeding, or intussusception. Herein, we report a case of BGH presenting with overt UGI bleed and features of gastric outlet obstruction. Esophagogastroduodenoscopy revealed a smooth polypoidal swelling in the posterior wall of the duodenal bulb. An endoscopic ultrasound (EUS) guided fine-needle-aspiration was performed, which was inconclusive. Contrast-enhanced computed tomography showed the absence of any extraluminal component of the lesion. Endoscopic polypectomy was attempted but failed due to the broad base of the lesion, and hence the patient was managed by open surgical excision. Histological examination of the resected specimen confirmed the diagnosis to be BGH. The patient had an uneventful recovery and was doing well at the 15-month follow-up. BGH should be considered as a differential diagnosis of a polypoidal lesion of the duodenum. Any lesion larger than 2 cm or symptomatic should be removed either by endoscopic or surgical intervention.
format Online
Article
Text
id pubmed-8312786
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-83127862021-07-29 Massive Upper Gastrointestinal Hemorrhage in Brunner’s Gland Hamartoma of Duodenum Dhali, Arkadeep Ray, Sukanta Ghosh, Ranajoy Sarkar, Avik Dhali, Gopal Krishna Cureus General Surgery Brunner's gland hamartoma (BGH) is a rare benign small bowel tumor, mostly encountered in the duodenum. Massive upper gastrointestinal (UGI) hemorrhage is an unusual presentation rarely reported in English literature. Symptomatic patients mostly present with features of gastric outlet obstruction, occult bleeding, or intussusception. Herein, we report a case of BGH presenting with overt UGI bleed and features of gastric outlet obstruction. Esophagogastroduodenoscopy revealed a smooth polypoidal swelling in the posterior wall of the duodenal bulb. An endoscopic ultrasound (EUS) guided fine-needle-aspiration was performed, which was inconclusive. Contrast-enhanced computed tomography showed the absence of any extraluminal component of the lesion. Endoscopic polypectomy was attempted but failed due to the broad base of the lesion, and hence the patient was managed by open surgical excision. Histological examination of the resected specimen confirmed the diagnosis to be BGH. The patient had an uneventful recovery and was doing well at the 15-month follow-up. BGH should be considered as a differential diagnosis of a polypoidal lesion of the duodenum. Any lesion larger than 2 cm or symptomatic should be removed either by endoscopic or surgical intervention. Cureus 2021-06-23 /pmc/articles/PMC8312786/ /pubmed/34336406 http://dx.doi.org/10.7759/cureus.15875 Text en Copyright © 2021, Dhali et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle General Surgery
Dhali, Arkadeep
Ray, Sukanta
Ghosh, Ranajoy
Sarkar, Avik
Dhali, Gopal Krishna
Massive Upper Gastrointestinal Hemorrhage in Brunner’s Gland Hamartoma of Duodenum
title Massive Upper Gastrointestinal Hemorrhage in Brunner’s Gland Hamartoma of Duodenum
title_full Massive Upper Gastrointestinal Hemorrhage in Brunner’s Gland Hamartoma of Duodenum
title_fullStr Massive Upper Gastrointestinal Hemorrhage in Brunner’s Gland Hamartoma of Duodenum
title_full_unstemmed Massive Upper Gastrointestinal Hemorrhage in Brunner’s Gland Hamartoma of Duodenum
title_short Massive Upper Gastrointestinal Hemorrhage in Brunner’s Gland Hamartoma of Duodenum
title_sort massive upper gastrointestinal hemorrhage in brunner’s gland hamartoma of duodenum
topic General Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312786/
https://www.ncbi.nlm.nih.gov/pubmed/34336406
http://dx.doi.org/10.7759/cureus.15875
work_keys_str_mv AT dhaliarkadeep massiveuppergastrointestinalhemorrhageinbrunnersglandhamartomaofduodenum
AT raysukanta massiveuppergastrointestinalhemorrhageinbrunnersglandhamartomaofduodenum
AT ghoshranajoy massiveuppergastrointestinalhemorrhageinbrunnersglandhamartomaofduodenum
AT sarkaravik massiveuppergastrointestinalhemorrhageinbrunnersglandhamartomaofduodenum
AT dhaligopalkrishna massiveuppergastrointestinalhemorrhageinbrunnersglandhamartomaofduodenum