A Case of a Huge Duodenal Brunner's Gland Hyperplasia

So called Brunner's gland hyperplasia is characterized by a nodular proliferation of histologically normal Brunner's gland, accompanied by ducts and scattered stromal element. The clinical presentation vary from vague epigastric disomfort to obstruction and gastrointestinal bleeding. We experienced a case of huge Brunner's gland hyperplasia presented as a huge duodenal polyp. A 28-year-old woman was refered to our hospital because of suspicious ampulla of Vater cancer or duodenal cancer in abdominal CT scan. The patient complained of dizziness and intermittent melena. The side view duodenoscopic examination revealed a huge pedunculated mass originated from the posterior wall of the duodenal bulb. The head of the polyp was placed on the ampulla of Vater with several erosions suggesting recent bleeding. Resection of duodenal polyp was performed by laparoscopic duodenotomy and Brunner's gland hyperplasia was revealed on pathologic examination.