Giant Brunner’s Gland Adenoma Presenting as Upper Gastrointestinal Bleeding in 76 Years Old Male: A Case Report

Ramesh Rana; Rikesh Sapkota; Bishal KC; Anish Hirachan; Bimas Limbu

Ramesh Rana Department of Internal Medicine, Gautam Buddha Community Heart Hospital, Butwal, Nepal
Rikesh Sapkota Department of Internal Medicine, Gautam Buddha Community Heart Hospital, Butwal, Nepal
Bishal KC Department of Cardiology, Gautam Buddha Community Heart Hospital, Butwal, Nepal
Anish Hirachan Department of Cardiology, Gautam Buddha Community Heart Hospital, Butwal, Nepal
Bimas Limbu Department of Surgery, Manipal Teaching Hospital, Pokhara, Nepal

Abstract

Brunner’s gland adenoma is a rare benign tumor of small bowel, often incidentally discovered during endoscopy or radiological imaging. Mostly they are asymptomatic or often present with nonspecific symptoms such as nausea, vomiting, gastrointestinal hemorrhage, iron deficiency anemia. We reported a 76 years old male case presented with chief complaints of vomiting and black tarry stool. General physical examination was normal except mild tenderness over epigastrium. Esophagogastroduodenoscopy revealed a pedunculated polypoid tubular structure with blind end distally of length approximately 10-12* 3.5*1.5 cm in the second section of the duodenum with multiple skipped ulcers on the exposed surface of it. Additionally, there were few erosions in the duodenum proximally and multiple superficial ulcerations in the antrum, associated with helicobacter pylori confirmed by rapid urease test kit.

Keywords: Brunner’s gland adenoma; Brunner’s gland hamartoma; Brunner’s gland hyperplasia; case report.