Surgical Resection for Hemorrhage in a Case of Brunners Gland Hyperplasia That Had Increased over the Course of 5 Years

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Brunners gland hyperplasia, a benign disease occurring mainly in the duodenal bulb, also causes hemorrhage or gastrointestinal obstruction. We report a case of Brunners gland hyperplasia followed with endoscopy over 5 years, resulting in surgery due to hemorrhage. A man in his 50s was referred to us after his medical checkup indicated a submucosal tumor-like protruding lesion with a diameter of approximately 15 mm in the duodenal bulb. Biopsy indicated the low possibility of a neoplastic lesion, and he was followed with esophagogastroduodenoscopy(EGD)annually. However, lesion size had increased year by year to 30 mm, and the patient was admitted to our department for further examination. Melena was observed from 2 to 3 days before admission; therefore, we performed EGD, which revealed the presence of erosion and hemorrhage on the lesion surface. We thought the lesion would tend to grow and that hemorrhage would likely recur, and we judged that the patient met the criteria for resection. Because endoscopic resection was difficult, we resected the lesion by partial duodenectomy. The histopathologic diagnosis was Brunners gland hyperplasia. This case was valuable because morphological changes leading to hemorrhage in this case of Brunners gland hyperplasia could be observed chronologically.
山口大学医学会の論文