BRUNNER GLAND ADENOMA - A RARE CAUSE OF D UODENAL OBSTRUCTION

Pseudo-tumoral hyperplasia of the Brunner glands is an exceptional dys embryoplastic or hyperplastic lesion which develops in the submucosa o f the supra papillary proximal duodenum. We report a case of Brunner a denoma which led to duodenal obstruction. In 50 % of the cases, the ad enoma was asymptomatic but non-specific signs may lead to barium studi es, CT scan of the abdomen or esogastroduodenal endoscopy which rarely provides formal histological proof. Major complications (hemorrhage, duodenal obstruction) and lack of formal diagnosis often leads to surg ery, ideally with tumor resection after duodenotomy. Other procedures (simple observation, endoscopic polypectomy, duodenopancreatectomy, bi liary or digestive bypass without tumorectomy) may be entertained depe nding on the functional status, the volume of the tumor, presence of c omplications and overall general status.