Two weeks before the patient had an episode of upper gastrointestinal bleeding and underwent an upper gastrointestinal endoscopy with hemostasis and biopsy of a 2cm duodenal polyp, which revealed Brunner's gland hyperplasia.
He underwent a repeat upper gastrointestinal endoscopy for hemostasis of bleeding Brunner's gland hyperplasia (Fig.
A well-defined histopathologic classification of Brunner's gland lesions is still lacking, and the terms hyperplasia, hamartoma, adenoma and Brunneroma are currently being used without distinction (3).
The biological behaviour of Brunner's gland hyperplasia is also unknown.
Brunner's gland hyperplasia is usually asymptomatic and diagnosed incidentally during upper gastrointestinal endoscopy (2).
Less frequently there are melena and haematemesis when erosion of the tumour occurs, which is described in Brunner's gland hyperplasia occurring beyond the first portion of the duodenum.
CT-scan and EUS examination can demonstrate the submucosal origin of Brunner's gland adenoma and exclude invasion of adjacent structures.
There are several cases of endoscopic polypectomy reported but success depends on the location and the size of Brunner's gland hyperplasia and clinical presentation.