Giant Brunner's gland hamartoma causing retrograde jejuno-duodenal intussusception: A case report.

Autor: Aldossary MY; Department of General Surgery, Surgical Oncology Section, King Fahad Specialist Hospital-Dammam, Saudi Arabia., Alzahir AA; Department of General Surgery, Surgical Oncology Section, King Fahad Specialist Hospital-Dammam, Saudi Arabia., Almulla LA; Department of Pathology and Laboratory Medicine, Histopathology Consultant, King Fahad Specialist Hospital-Dammam, Saudi Arabia., Alhajji ZH; Department of General Surgery, Surgical Oncology Section, King Fahad Specialist Hospital-Dammam, Saudi Arabia., Alsaif OH; Department of General Surgery, Surgical Oncology Section, King Fahad Specialist Hospital-Dammam, Saudi Arabia.
Jazyk: angličtina
Zdroj: Annals of medicine and surgery (2012) [Ann Med Surg (Lond)] 2019 Jan 04; Vol. 38, pp. 37-41. Date of Electronic Publication: 2019 Jan 04 (Print Publication: 2019).
DOI: 10.1016/j.amsu.2018.12.007
Abstrakt: Brunner's gland hamartoma is a rare benign duodenal tumor. It occurs in Brunner's glands, which are found in the duodenum and produce secretions that protect the duodenum from pancreatic enzymes, gastric acid, and other agents. Endoscopic or surgical resection is required for these hamartomas. Duodenal intussusception is a relatively rare condition, usually caused by the presence of benign tumors, such as fibroadenomas, lipomas, papillomas, or sometimes with malignant neoplasms. We report a case of giant Brunner's gland hamartoma in the duodenum causing antiperistaltic intussusception in a 45-year-old female patient. The patient reported a 3-year history of chronic anemia, and this mass was detected incidentally by computed tomography (CT) during investigations for chronic anemia and weight loss. Pre-operative abdominal and pelvis contrast revealed a sausage-shaped intraluminal structure with alternating fat planes and vessels distended in the third part of the duodenum up to the first part of the duodenum. Pancreas-sparing duodenectomy was performed. The patient recovered very slowly and was discharged on postoperative day 15 in good condition. Histology showed a large polypoid mass measuring 12.0 × 7.5 × 2.0 cm 3 , consistent with Brunner's gland hamartoma. Brunner's gland hamartoma can present with features of duodenal intussusception or ampullary obstruction but is rarely seen to cause retrograde jejuno-duodenal intussusception. Pancreas-sparing duodenectomy is the best surgical option in adult patients with intestinal intussusception associated with giant lesions close to the ampulla of Vater, especially in the presence of features of malignancy.
Databáze: MEDLINE