유문부의 Ball-valve 폐쇄를 보인 거대 브루너 선종의 Endoclip과 IT-knife를 이용한 절제술 1예 = A Case of Brunner's Gland Adenoma Causing a Ball-valve Obstruction: Endoscopic Treatment with a Simple Method of Endoclip-assisted Direct Resection with Using an IT-knife

다국어 초록 (Multilingual Abstract)

Brunner's gland adenoma is a rare benign tumor that is usually asymptomatic and it the result of a benign proliferation of the Brunner's glands of the duodenum. In symptomatic patients, the common clinical presentation is gastrointestinal bleeding and obstructive symptoms. A 48-year-old man presented with abdominal discomfort and vomiting. The endoscopic examination revealed a large pedunculated polypoid mass arising in the bulb and it was prolapsing through the pylorus into the antrum, and this all resulted in a ball-valve obstruction. After endoclips were applied at the peduncle of the mass, this polyp was simply and successfully cut with using an IT-knife without bleeding or perforation. We report here on a case of Brunner's gland adenoma that caused a ball-valve obstruction, and the tumor was removed by a simple and easy method with using endoclips and an IT-knife.

국문 초록 (Abstract)

브루너 선종은 십이지장에 정상적으로 존재하는 브루너 선의 증식으로 발생되며 대부분 증상을 동반하지 않는 양성 종양이다. 증상이 있는 경우 가장 흔한 증상은 위장관 출혈과 장폐쇄 증상이다. 48세 남자가 상복부 불쾌감과 구토를 주소로 내원하였다. 내시경 소견상 십이지장 구부에 거대 유경성 용종이 관찰되었고 간헐적으로 유문부를 통하여 위전정부로 돌출되어 ball-valve 효과에 의한 폐쇄 증상을 보였다. 치료로 endoclip과 IT-knife를 이용한 내시경적 절제를 시행하였고 합병증 없이 성공적으로 제거되었다. 저자들은 ball-valve 효과에 의한 장폐쇄 증상을 보이는 거대 브루너 선종을 1예 경험하여 문헌 고찰과 함께 보고한다.

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