SUPERFICIAL NONAMPULLARY DUODENAL TUMORS AS BENIGN GASTRIC OUTLET OBSTRUCTION (GOO).CASE REPORT OF BRUNNER‘S GLAND HYPERPLASIA (BGH). rmaskelis@googlemail.com

 

SUPERFICIAL NONAMPULLARY DUODENAL TUMORS AS BENIGN GASTRIC OUTLET OBSTRUCTION (GOO).CASE REPORT OF BRUNNER‘S GLAND HYPERPLASIA (BGH).

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Lithuania

Oral only

GOO by the BGH is rare pathology usually found incidentally on endoscopy. This benign condition was first described in 1835 and in the literature is described less than 200 cases reported. Definition : BGH also known as Brunneroma or polypoid hamartoma is a rare, benign, proliferative lesion arising from the Brunner‘s gland of the duodenum, which was accurately described by Brunner in 1688. The abnormal glandular proliferation are classified into the following three types: diffuse (type 1), nodular (type 2) and adenomatous (type 3) hyperplasia (Feyrter).

Since that time, numerous case reports of benign duodenal lesions have appeared in the literature. In a monumental piece of work River, Silverstein and Tope reviewed 1,399 benign small intestinal tumors reported in the literature. Their study included 211 benign duodenal tumors. Our case. A 38 year old woman underwent gastroscopy due to epigastric discomfort, weight loss, nausea, and reflux symptoms, during which a flat tumor consisting of BGH confirmed histologically. Due to the large size of the flat tumor, a routine radiological examination is performed to evaluate the barium on single- and double-contrast technique and radiographically the GOO was confirmed (File 1). The patient underwent EMR as the ESD has a more large risk of duodenal perforation (File 2).

On classification of this pathology and clinical evidence for the surgical treatment. Which surgical treatment preferring now?

We recommend endoscopy for the evaluation of patients with suspected GOO when radiologic studies are inconclusive, or unrevealing or when endoscopy therapy is indicated.