title: A large Brunner's gland hamartoma causing gastrointestinal bleeding and obstruction.
abstract: BACKGROUND
  Clinical symptoms of Brunner's gland (BG) hamartoma are rare. Most lesions are small and asymptomatic. Symptomatic BG hamartoma may mimic a malignancy of the duodenal-pancreatic area. Though standard mucosal biopsies are inferiorly diagnostic due to normal duodenal mucosa surrounding, a biopsy was indicated in this case.
  
  
  METHODS
  We report the case of a 37-year-old man with a large BG hamartoma mimicking a malignancy. Preoperatively the biopsy led to an inconclusive diagnosis. Due to its large size and its presence of symptoms, a surgical excision was performed.
  
  
  CONCLUSIONS
  BG hamartoma may be a rare indication for surgery.
authors.affiliation: Division of Gastrointestinal Surgery, Flevoziekenhuis, Almere, The Netherlands. lcdenes@amc.uva.nl
authors.forename: L C F
authors.initials: LC
authors.lastname: de Nes
authors.forename: F
authors.initials: F
authors.lastname: Ouwehand
authors.forename: S H A
authors.initials: SH
authors.lastname: Peters
authors.forename: M J
authors.initials: MJ
authors.lastname: Boom
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D002011:Brunner Glands; D004378:Duodenal Diseases / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D004380:Duodenal Obstruction / Q000209:etiology*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006222:Hamartoma / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed