Excessive nodular hyperplasia of Brunner glands associated with gastric hypersecretion and lipomatous atrophy of the pancreas

The case of a 34-year-old woman complaining of diarrhoea and abdominal pain is presented. Contrast radiography and endoscopy showed multiple polypoid tumours in the second part of the duodenum. Moreover, a severe fatty infilt ration of the pancreas was shown by magnetic resonance and computed tomogra phy scans. Due to pain, pancreatoduodenectomy (Whipple operation) was perfo rmed, and subsequent histopathologic examinations showed excessive Brunner gland hyperplasia of the duodenum and severe lipomatous atrophy of the panc reas. The occurrence of these two rare conditions in one patient has not be en described previously, and it is conceivable that the lipomatous atrophy and exocrine insufficiency of the pancreas may have caused a compensatory s timulation of the submucosal structures of the duodenum.