Brunner Bezi Adenomu: Üst Gastrointestinal Kanama ile Seyreden Nadir Bir Olgu

Abstract

Özet Giriş: Brunner bezi adenomu, duodenumdaki Brunner bezlerinin aşırı proliferasyonundan kaynaklanan nadir, benign bir tümördür. Tüm duodenal tümörlerin yaklaşık %1’ini oluşturur ve genellikle asemptomatiktir. Ancak bazı vakalarda gastrointestinal kanama, obstrüksiyon veya dispeptik semptomlara neden olabilir. Olgu Sunumu: Bu çalışmada, halsizlik, bulantı, kusma ve melena şikâyetleri ile acil servise başvuran 58 yaşında kadın hasta sunulmaktadır. Hastanın koroner arter hastalığı öyküsü vardı ve günlük asetilsalisilik asit tedavisi almaktaydı. Üst gastrointestinal endoskopide, duodenum bulbusta, yüzeyi düzensiz ve pıhtılı, kısmi lümen tıkanıklığına yol açan, 1,8 × 1,6 × 1 cm boyutlarında saplı bir polip saptandı. Endoskopik polipektomi başarıyla gerçekleştirildi ve histopatolojik inceleme Brunner bezi adenomu tanısını doğruladı. Malignite veya displazi saptanmadı. Tartışma: Brunner bezi adenomları, endoskopik değerlendirme sırasında saptanan duodenal poliplerin ayırıcı tanısında dikkate alınmalıdır. Tipik olarak benign olmalarına rağmen, bu lezyonlar ciddi klinik semptomlara yol açabilir ve maligniteyi taklit edebilir. Küçük ve saplı lezyonlarda endoskopik polipektomi tercih edilen tedavi yöntemidir; daha büyük veya geniş tabanlı lezyonlarda cerrahi eksizyon gerekebilir. Rekürrens veya komplikasyonların izlenmesi için dikkatli takip önemlidir.

Keywords

• Brunner bezi adenomu
• duodenal polip
• gastrointestinal kanama
• endoskopik polipektomi
• benign duodenal tümör

Brunner Gland Adenoma: A Rare Case Presenting with Upper Gastrointestinal Bleeding

Abstract

Introduction Brunner gland adenoma is a rare benign tumor originating from the excessive proliferation of Brunner glands in the duodenum. It accounts for approximately 1% of all duodenal tumors and is often asymptomatic. However, in some cases, it may cause gastrointestinal bleeding, obstruction, or dyspeptic symptoms. Case Presentation: We present the case of a 58-year-old female who was admitted to the emergency department with fatigue, nausea, vomiting, and melena. She had a history of coronary artery disease and was on daily acetylsalicylic acid therapy. Upper gastrointestinal endoscopy revealed a pedunculated polyp measuring 1.8 × 1.6 × 1 cm in the duodenal bulb, with an irregular clotted surface causing partial luminal obstruction. Endoscopic polypectomy was successfully performed, and histopathological examination confirmed the diagnosis of Brunner gland adenoma. No malignancy or dysplasia was detected. Discussion: Brunner gland adenomas should be considered in the differential diagnosis of duodenal polyps detected during endoscopic evaluation. Although typically benign, these lesions can lead to significant clinical symptoms and may mimic malignancy. Endoscopic polypectomy is the preferred treatment for small and pedunculated lesions, while surgical excision may be required for larger or broad-based lesions. Careful follow-up is essential to monitor for recurrence or complications.

Keywords

• Brunner gland adenoma
• gastrointestinal bleeding
• benign duodenal tumor
• endoscopic polypectomy

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