下血を主訴とした十二指腸球部のブルンネル腺腺腫の1例

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  • A case of adenoma of Brunner's glands in the duodenal bulb

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This is a case report of adenoma of Brunner's glands in the duodenal bulb. A 71-year-old female was admitted to my hospital with chief complaints of melena and severe anemia for a few months. Upper gastrointestinal X-ray series showed a ro-und shaped, irregular surface, filling defect in the duodenal bulb. This was believed to be a polyp. Hypotonic duodenography revealed a pedunculated polyp like lesion in the posterior wall of the duode-nal bulb. A round but well lobulated, protruding lesion with pedicule was seen by Duodenoscopy in the duodenal bulb. Erosion was noticed over the surface of this lesion. At operation, a pedunculated tumor, 4.0×4.0×3.5 cm in size, was found in the posterior wall of the duodenum immediately distal to the pylorus. The tumor was resected by Billroth-I method. Histologically it was diagnosed to be adenoma of Brunner's glands. Endoscopic examination is very useful for the dia-gnosis of duodenal tumor, however, special attension must be given in case's involving submucosal type of benign duodenal tumor.

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