title: Neuromuscolar and vascular hamartoma of the duodenum. A clinical case and review of the literature.
abstract: OBJECTIVE
  The NMVH of the intestine is a rare lesion, typical located in the small bowel. After the first 2 cases, reported in 1982, other 12 cases have been described, ten localized in the jejunual or ileal tract, only 1 in the cecum.
  
  
  METHODS
  A case of NMVH of the duodenum, simulating a Crohns disease, is described. The lesion extended about 12 cm. and it caused intestinal stenosis. The microscopic analysis on the operative specimen highlighted the presence of a neuronal hyperplasia at mucous membranae and submucosal levels, associated to muscolaris mucosae hypertrophy and disorganisation. Expanded and ectasic veins, proliferation of nervous fibres and ganglion cells in the submucosal were also observed.
  
  
  RESULTS
  NMVH is a non-epithelial hamartomatous, submucosally based proliferation of mature submucosal elements capable of causing small bowel obstruction. In the controversy about the nature of the NMVH, we consider it a separate entity, where the final diagnosis depend on the clinicopathologic setting, as well as on the location and number of the lesions.
  
  
  CONCLUSIONS
  The Authors analyse the main characteristics of this rare pathology with regard to clinical, diagnostic and therapeutic aspects.
authors.affiliation: Department of Surgery, Policlinic S. Orsola - Malpighi, University of Bologna, Italy. minnichir@orsola-malpighi.med.unibo.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Minni
authors.forename: Alessandra
authors.initials: A
authors.lastname: Margiotta
authors.forename: Enrico
authors.initials: E
authors.lastname: Guerra
authors.forename: Nicola
authors.initials: N
authors.lastname: Marrano
authors.forename: Saverio
authors.initials: S
authors.lastname: Selva
authors.forename: Claudio
authors.initials: C
authors.lastname: Ricci
authors.forename: Tommaso
authors.initials: T
authors.lastname: Grottola
authors.forename: Donatella
authors.initials: D
authors.lastname: Santini
mesh_terms: D001706:Biopsy; D003937:Diagnosis, Differential; D004378:Duodenal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D004386:Duodenum / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006222:Hamartoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D013997:Time Factors; D014057:Tomography, X-Ray Computed