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Canadian Journal of Gastroenterology
Volume 16 (2002), Issue 5, Pages 309-313
http://dx.doi.org/10.1155/2002/797934
Brief Communication

Brunner’s Gland Hamartoma: A Rare Cause of Gastrointestinal Bleeding – Case Report and Review of the Literature

David R Stolpman,1 Gordon C Hunt,1 Brett Sheppard,2 Hahn Huang,3 and Deepak V Gopal1

1Division of Gastroenterology, Oregon Health Sciences University, Portland, Oregon, USA
2Department of Surgery, Oregon Health Sciences University, Portland, Oregon, USA
3Department of Pathology, Oregon Health Sciences University, Portland, Oregon, USA

Received 6 December 2001; Accepted 15 April 2002

Copyright © 2002 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

An unusual cause of upper gastrointestinal bleeding is described in a previously healthy 45-year-old man who was admitted to hospital with weakness and fatigue, and had experienced an episode of melena two days before admission. His medical and surgical history was unremarkable. Upon admission to hospital, he showed evidence of iron-deficiency anemia, with a hemoglobin concentration of 61 g/L (normal range 135 to 175 g/L), a mean corpuscular volume of 73 fL (normal range 85.0 to 95.0 fL) and a ferritin concentration of 1.0 µg/L (normal range in males 15 to 400 µg/L). Upper gastrointestinal endoscopy revealed a 3.5 cm ulcerated submucosal mass in the third portion of the duodenum, for which mucosal biopsies were nondiagnostic. A subsequent endoscopic ultrasound revealed a 2.7×4.0 cm hyperechoic, cystic, submucosal tumour in the third portion of the duodenum. Endoscopic ultrasound-guided fine needle aspiration revealed no malignant cells. The patient eventually underwent a resection of the third portion of his duodenum. Surgical pathology revealed that this tumour was a Brunner’s gland hamartoma, 4.5 cm in its greatest dimension.