A Giant Brunneroma Causing Gastrointestinal Bleeding and Severe Anemia Requiring Transfusion and Surgery

Table 1

Reported cases of Brunner’s gland hamartomas larger than 5 cm and concomitant interventional approaches.

Reference	Size (cm)	Clinical presentation	Clinical intervention
[28]	5.5 × 3.3 × 2.2	Melena, dizziness, weakness	Duodenotomy
[18]	5.5 × 4.2 × 4.3	Recurrent pancreatitis	Pyloroduodenotomy
[29]	5.5	Upper abdominal pain	Duodenocephalopancreatectomy
[30]	5-6	Jaundice, abdominal pain	Pancreaticoduodenectomy
[15]	5 × 6	Melena, diarrhea, epigastric discomfort, weight loss, anemia	Pyloroduodenotomy
[31]	6	Anemia	Duodenotomy
[32]	6	Screen for gastric cancer	Endoscopic polypectomy
[33]	6 × 2.4	Melena, weakness, palpitations	Excisional pyloroduodenoplasty
[34]	6.0 × 0.4 × 0.2	Melena	Endoscopic polypectomy
[35]	6 × 3	Epigastric pain, nausea, vomiting, melena	Transduodenal; polypectomy
[36]	6 × 3.5	Upper abdominal pain	Laparoscopic and endoscopic tumor resection
[37]	6 × 4	Weakness, anemia	Laparoscopic transduodenal polypectomy
[12]	6.4 × 3	Melena, anemia	Distal gastrectomy with lymph node dissection
[19]	6 × 5 × 3	Upper abdominal pain, nausea, weight loss	Transduodenal polypectomy
[38]	6.5 × 4 ×4	Abdominal pain	Endoscopic polypectomy
[39]	6.6 × 4.5	Epigastric pain, nausea, vomiting, weight loss	Pancreaticoduodenectomy
[17]	7	Abdominal pain, melena	Endoscopic polypectomy
[40]	7.3 × 3.4 × 2.9	Melena	Transduodenal; polypectomy and pyloroplasty
[41]	7.3 × 3.4 × 2.9	Melena	Pancreaticoduodenectomy
[42]	7.5 × 6.5 × 6.5	Epigastric pain	Partial duodenectomy
[16]	7.9	Upper abdominal pain, vomiting, weight loss	Distal gastrectomy and Billroth II reconstruction
[43]	8	Abdominal pain, weight loss, melena	Transduodenal polypectomy
[5]	8 × 10	Upper abdominal pain, vomiting	Pancreaticoduodenectomy
[44]	10	Fatigue, melena	Polypectomy (surgical approach not described)
[2]	10 × 2 × 1.5	Melena, dizziness,; dyspnea on exertion	Transduodenal polypectomy
[45]	10.5	Referred for further evaluation of a polypoid lesion in the duodenum	Endoscopic polypectomy
[4]	10.5	Epigastric abdominal pain, reflux symptoms	Pancreaticoduodenectomy
[46]	10 × 6 × 8	Vomiting, melena	Distal gastrectomy and partial duodenectomy
[47]	10–12	Weakness, fatigue, melena	Laparoscopic transduodenal polypectomy and pyloroplasty
[48]	12 × 10 × 8	Vomiting, weakness, weight loss	Duodenotomy and partial gastrectomy