Abstract

MEWA KINOO, S; NAIDOO, R  and  SINGH, B. Duodeno-duodenal intussusception secondary to a Brunner's gland adenoma. S. Afr. j. surg. [online]. 2018, vol.56, n.1, pp.42-45. ISSN 2078-5151.  https://doi.org/10.17159/2078-5151/2018/v56n1a2292.

Duodenal intussusception is a rare complication of a Brunner's gland adenoma with only 12 cases, including this report, reported to date. Symptoms are usually vague, diagnosis is often difficult and intussusception, due to its rarity, may mimic sinister tumours. Management usually involves a duodenotomy and excision of the adenoma. We present a 46-year-old female who presented with features of intermittent gastric outlet obstruction with associated anaemia. A combination of fluoroscopy, endoscopy and computed tomography revealed a duodenal intussusception with a lead point from the 1^st part of the duodenum intussuscepting into the 4^th part of the duodenum. At laparotomy the Brunner's adenoma was removed via an antrotomy. A Brunner's gland adenoma must be suspected for tumours arising in the 1^st part of the duodenum. Though rare, intussusception may mimic more sinister tumours and must be considered as an alternate diagnosis to prevent unnecessary major resections. Excision via an antrotomy rather than a duodenotomy should be considered.

Keywords : Brunner's gland; Brunner's gland adenoma; duodenal intussusception; duodeno-jejunal intussusception.

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