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題名 | Duodenal Brunner's Gland Adenoma: Clinical Analysis of Eight Cases=十二指腸布隆納氏腺瘤:八個病例之臨床分析 |
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作者 | 詹昆明; 詹益銀; 鄭隆賓; 黃燦龍; 林淳榮; 黃秀芬; 陳敏夫; | 書刊名 | 臺灣外科醫學會雜誌 |
卷期 | 36:3 民92.05-06 |
頁次 | 頁125-131 |
分類號 | 416.243 |
關鍵詞 | 十二指腸; 布隆納氏腺瘤; Brunner's gland adenoma; Duodenal tumor; |
語文 | 英文(English) |
英文摘要 | Background: Brunner's gland adenoma is an uncommon intestinal tumor,frequently located in the duodenal bulb. This investigation reports a series ofpatients with Brunner's adenoma treated at Chang Gang Memorial Hospital. Methods: The medical records of patients with Brunner's gland adenoma werereviewed. Their clinical characters, endoscopic features, radiological findings,management, and histological features were thoroughly investigated and discussed. Results: Totally, 8 patients (5 men and 3 women) were admitted to this study, withages ranging between 24 and 60 years old. Patients presented with hemorrhage(n=4), obstruction (n=l), or incidental finding (n=l). Additionally, one patient hadsymptoms of hemorrhage concomitant with obstruction, and one patient sufferedfrom long-term dull epigastralgia and epigastric fullness. Tumors were generallypedunculated and polypoid, located in the first portion of the duodenum, andranged between 3 and 8 cm at their maximum dimension. These patients weremanaged with duodenotomy followed by polypectomy (n=3), endoscopicpolypectomy (n=2), subtotal gastrectomy (n=2), and bypass with gastrojejunostomy(n=l). Histologically, Brunner's gland adenomas are composed of lobules ofproliferating Brunner's glands separated by strands of smooth muscle fibers. Theoutcome of the patients reviewed herein was predominantly favorable, and noadditional major morbidity was identified. Condusion: Brunner's gland adenomas are uncommon duodenal tumors oc-curring in middle age. They present with gastrointestinal hemorrhage, obstructivesymptoms, or incidentally. Panendoscopy and endoscopic ultrasonography mightbe helpful in diagnosing Brunner's gland adenoma, and surgical and endoscopicexcision is uncomplicated and favorable. Small or asymptomatic tumors can bemanaged by either expectant or endoscopic excision, while larger tumors causingsymptoms can be treated surgically either through resection or alternative bypass. |
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