A Giant Brunneroma Causing Gastrointestinal Bleeding and Severe Anemia Requiring Transfusion and Surgery

Frenkel, Nicola; Rinkes, Inne H.M. Borel; Molenaar, I.; Hagendoorn, Jeroen

doi:10.1155/2017/6940649

Cited by 7 publications

(8 citation statements)

References 42 publications

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“…[ 4 , 14 ] Our case presented with BGA-related blood loss, which led to hemodynamic instability. Although some studies have reported cases with gastrointestinal bleeding as the main clinical manifestation, [ 5 – 6 ] our case show larger lesion size. In addition, age of the patient was older (81 years) than previously reported of 76 years old.…”

Section: Discussioncontrasting

confidence: 61%

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A case report of endoscopic resection for the treatment of duodenal Brunner's gland adenoma with upper gastrointestinal bleeding

Zhang

Song

et al. 2020

Medicine

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Rationale: Gastrointestinal bleeding as the first sign of Brunner's gland adenoma (BGA) is an extremely rare, and its clinical features and treatment methods have not been well described. Patient concerns: We described a 81-year-old female patient with coronary artery disease and chronic atrial fibrillation presenting with presenting with gastrointestinal bleeding requiring blood transfusion. Diagnoses: The diagnosis of our case mainly refered to radiologic imaging and endoscopic examination. Histological result was compatible with BGA. Interventions: This mass lesion (6 × 7 cm diameter) was successfully totally removed by endoscopic submucosal dissection (ESD) for more than three hours. Outcomes: The patient was followed up for 6 months to date without recurrence. Lessons: Endoscopic removal is considered as a safe and low-risk treatment for elderly patients with severe underlying diseases presenting with gastrointestinal bleeding.

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Section: Discussioncontrasting

confidence: 61%

“…[ 3 ] When they reach giant dimensions, they may obstruct the gastric outlet or duodenum, which requires surgery or endoscopic resection. [ 4 ] Although a few case reports have previously described BGA patients with gastrointestinal bleedings, [ 5 – 6 ] there are no systematic reports on the clinical features and treatments.…”

Section: Introductionmentioning

confidence: 99%

A case report of endoscopic resection for the treatment of duodenal Brunner's gland adenoma with upper gastrointestinal bleeding

Zhang

Song

et al. 2020

Medicine

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“…Clinical symptomatic presentation of BGH is caused by gastrointestinal bleeding or obstruction, leading to abdominal pain, nausea, vomiting, melena, or anemia. Two cases developed severe anemia and required blood transfusions [ 4 , 5 ]. In some cases, when the tumor obstructed the ampulla of Vater, pancreatitis or jaundice occurred [ 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

Large Brunner’s Gland Hyperplasia with Bleeding: A Case Report

Okutomi

Kato

Aizawa

et al. 2021

Case Reports in Surgery

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We report a rare case of a large Brunner’s gland hyperplasia (BGH) with severe anemia. A 33-year-old woman was transferred to our hospital with anemia and a duodenal mass. She had a 2-week history of melena and mild shortness of breath. Her hemoglobin level was 4.9 g/dl, and she required a blood transfusion. Abdominal computed tomography revealed a 7 cm tumor in the descending duodenum, and duodenoscopy revealed a polyp-like tumor with an ulcer at the duodenal bulb. We decided to perform surgery to prevent further bleeding. Intraoperatively, the tumor stalk was located at the anterior wall of the duodenal bulb; the ampulla was not involved, and we resected the tumor with the wall of the duodenal bulb. The resected tumor measured 7.0 × 4.0 × 2.3 cm , and pathologically, the tumor consisted of proliferated Brunner’s glands in a small amount of fibrous stroma. The histological diagnosis was BGH with no malignancy. Most cases of BGH are benign and asymptomatic; however, it is important to be aware that some patients have severe anemia, gastrointestinal obstruction, or malignant potential.

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“…As Table 1 shows, in reported cases of Brunner’s gland hamartomas larger than 5 cm, all the exophytic BGH and sessile BGH are removed surgically, while Endoscopic resection was only performed in the pedunculated BGH. In addition, surgical treatment was also chosen in the pedunculated mass in the following cases: [1] Malignancy of the mass can not be excluded; [2] some emergency complications like intussusception; [3] The mass was too large, or the stalk was too thick to be removed endoscopically. Therefore, preoperative diagnosis and endoscopic evaluation are important to proper selection of the interventional approach.…”

Section: Discussionmentioning

confidence: 99%

“…Brunner’s gland hamartoma (BGH) is a benign tumor of the duodenum arising from the Brunner’s glands [2]. Most patients are asymptomatic, but some may present with common gastrointestinal symptoms such as bleeding, nausea, vomiting, and chronic abdominal pain [3]. Brunner’s gland hamartoma can be treated either by endoscopic or surgical excision [4].…”

Section: Introductionmentioning

confidence: 99%

A giant Brunner’s gland hamartoma being treated as a pedunculated polyp: a case report

Cheng

Qiu

et al. 2019

BMC Gastroenterol

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Background With the development and application of endoscopic technology, most pedunculated polyps can be absolutely resected with a complete specimen by hot snare polypectomy (HSP). Brunner’s gland hamartoma (BGH) is a rare benign small bowel tumor. The majority of BGH measuring about 2 cm in diameter, rarely larger than 5 cm. Most patients are asymptomatic, some may present with gastrointestinal hemorrhage or intestinal obstruction. Symptomatic larger lesions leading to bleeding or obstruction should be excised either endoscopically or surgically. Whether it is safe and effective that removing a BGH measuring about 7 cm by HSP is not known. Case presentation Here, we reported a rare case of a proximal duodenum pedunculated mass measuring about 7 cm which was responsible for the patient’s severe anemia. we treated it as a pedunculated polyp. After being pretreated the stalk with an endoloop which was placed around the base of the mass to prevent post-polypectomy bleeding (PPB), the pedunculated BGH was removed by HSP completely. The stalk of the mass was negative. We achieved a curative resection. Conclusion It is a safe and effective for our patient to treat the pedunculated BGH measuring about 7 cm as a pedunculated polyp and remove it by HSP. And future prospective studies in larger cohorts are needed to confirm it.

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A Giant Brunneroma Causing Gastrointestinal Bleeding and Severe Anemia Requiring Transfusion and Surgery

Cited by 7 publications

References 42 publications

A case report of endoscopic resection for the treatment of duodenal Brunner's gland adenoma with upper gastrointestinal bleeding

A case report of endoscopic resection for the treatment of duodenal Brunner's gland adenoma with upper gastrointestinal bleeding

Large Brunner’s Gland Hyperplasia with Bleeding: A Case Report

A giant Brunner’s gland hamartoma being treated as a pedunculated polyp: a case report

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