title: Biliary obstruction and pancreatitis caused by diffuse nodular hyperplasia of Brunner's gland.
abstract: BACKGROUND
  Brunner's gland hyperplasia (BGH) of the duodenum is an uncommon finding at endoscopy and is usually asymptomatic. Symptomatic BGH presenting with biliary obstruction and pancreatitis is extremely rare and the literature is limited to a few case reports.
  
  
  METHODS
  We report an unusual case of diffuse BGH of duodenum involving the ampulla of Vater that led to this clinical presentation. Biopsies revealed BGH and successful endoscopic therapy utilizing sphincterotomy and plastic stent placement led to complete recovery.
  
  
  CONCLUSIONS
  Albeit its uncommon clinical presentation, it can become challenging in terms of diagnosis and management. A high index of suspicion is of paramount importance for establishing the correct diagnosis and treatment.
authors.affiliation: SOM, Wright State University, Dayton, OH, USA. rekibria@gmail.com
authors.forename: Rizwan
authors.initials: R
authors.lastname: Kibria
authors.forename: Syed A
authors.initials: SA
authors.lastname: Ali
authors.forename: Shazdeh
authors.initials: S
authors.lastname: Butt
authors.forename: Salma
authors.initials: S
authors.lastname: Akram
mesh_terms: D002011:Brunner Glands / Q000473:pathology*; D002779:Cholestasis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D004378:Duodenal Diseases / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D016145:Endoscopy, Digestive System; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D015607:Stents