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Gastric Outlet Obstruction Caused by a Triple Lesion: Eosinophilic Gastroenteritis, Brunner’s Gland Hyperplasia and Pancreatic Heterotopia in Unison

Received: 1 March 2017     Accepted: 30 March 2017     Published: 3 May 2017
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Abstract

Gastric outlet obstruction is a common entity described with numerous benign and malignant causes. Historically, benign causes include Peptic Ulcer disease (PUD); however recent cases have reported other causes including Eosinophilic Gastroenteritis (EGE), Brunner’s Gland Hyperplasia (BGH) and Pancreatic Heterotopia (PH). We present an unusual case of a 31 year old male patient with severe gastric outlet obstruction requiring surgical intervention caused by all three pathologies in unison – EGE, BGH and PH. The patient underwent surgical resection with distal gastrectomy and Billroth II reconstruction. Histology confirmed the three pathologies and post-operative recovery of the patient was uneventful.

Published in Journal of Surgery (Volume 5, Issue 3)
DOI 10.11648/j.js.20170503.12
Page(s) 43-46
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Eosinophilic Gastroenteritis, Brunner’s Gland Hyperplasia, Pancreatic Heterotopia

References
[1] Appasani S, Kochhar R, Nagi B, Gupta V. Benign gastric outlet obstruction--spectrum and management. Trop Gastroenterol. 2011; 32(4):259-66.
[2] Mori A, Enweluzo C, Grier D, Badireddy M. Eosinophilic gastroenteritis: Review of a Rare and Treatable disease of the Gastrointestinal Tract. Case Rep Gastroenterol 2013; 7(2):293-8.
[3] Talley NJ, Shorter RG, Phillips SF, Zinmeister AR. Eosinophilic Gastroenteritis:a clinicopathological study of patients with disease of mucosa, muscle layer and subserosal tissues. Gut. 1990; 31:54-5.
[4] Chaudhary R, Shrivastava RK, Mukhopadhyay HG, Diwan RN, Das AK. Eosinophilic gastritis--an unusual cause of gastric outlet obstruction. Indian J Gastroenterol 2001; 20(3):110.
[5] Suraweera DB, Amin J, Baltayan A, Hu R. Brunner’s Gland Hyperplasia: A Rare Cause Of Gastric Outlet Obstruction and a Review of Treatment Strategies. J Gastroenterol Hepatol Res. 2015; 4(7):1698-701.
[6] Krishnamurthy P, Junaid O, Moezzi J, MD, Ali SA, Gopalswamy N. Gastric outlet obstruction caused by Brunner's gland hyperplasia: case report and review of literature. GIE.2006; 64(3):464–67.
[7] Dhinakar M, Allaya DJ, Golash. A Rare Case of Brunneroma Duodenum causing Gastric Outlet Obstruction. OMJ. 2010;25: 44-46.
[8] Deshpande VP, Raghunath BV, Sarin YK, Sinha S. Heterotopic pancreas causing duodenal obstruction in a patient previously treated for choledochal cyst. J Indian Assoc Pediatr Surg. 2012; 17(1):40–2.
[9] Trifan A, Tarcoveanu E, Danciu M, Hutanasu, Cojocariu C. Gastric Heterotopic Pancreas:An unusual case and Review of Literature. J Gastrointestin Liver Dis. 2012; 21(2):209-12.
[10] Ormarsson OT, Haugen SE, Juul I. Gastric outlet obstruction caused by Heterotopic pancreas. Eur J Pediatr Surg. 2003; 13(6):410-3.
Cite This Article
  • APA Style

    Apurva Sharma, Sonmoon Mohapatra, Kheng-Jim Lim, Abhijeet Chaubal, Arkady Broder. (2017). Gastric Outlet Obstruction Caused by a Triple Lesion: Eosinophilic Gastroenteritis, Brunner’s Gland Hyperplasia and Pancreatic Heterotopia in Unison. Journal of Surgery, 5(3), 43-46. https://doi.org/10.11648/j.js.20170503.12

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    ACS Style

    Apurva Sharma; Sonmoon Mohapatra; Kheng-Jim Lim; Abhijeet Chaubal; Arkady Broder. Gastric Outlet Obstruction Caused by a Triple Lesion: Eosinophilic Gastroenteritis, Brunner’s Gland Hyperplasia and Pancreatic Heterotopia in Unison. J. Surg. 2017, 5(3), 43-46. doi: 10.11648/j.js.20170503.12

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    AMA Style

    Apurva Sharma, Sonmoon Mohapatra, Kheng-Jim Lim, Abhijeet Chaubal, Arkady Broder. Gastric Outlet Obstruction Caused by a Triple Lesion: Eosinophilic Gastroenteritis, Brunner’s Gland Hyperplasia and Pancreatic Heterotopia in Unison. J Surg. 2017;5(3):43-46. doi: 10.11648/j.js.20170503.12

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  • @article{10.11648/j.js.20170503.12,
      author = {Apurva Sharma and Sonmoon Mohapatra and Kheng-Jim Lim and Abhijeet Chaubal and Arkady Broder},
      title = {Gastric Outlet Obstruction Caused by a Triple Lesion: Eosinophilic Gastroenteritis, Brunner’s Gland Hyperplasia and Pancreatic Heterotopia in Unison},
      journal = {Journal of Surgery},
      volume = {5},
      number = {3},
      pages = {43-46},
      doi = {10.11648/j.js.20170503.12},
      url = {https://doi.org/10.11648/j.js.20170503.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20170503.12},
      abstract = {Gastric outlet obstruction is a common entity described with numerous benign and malignant causes. Historically, benign causes include Peptic Ulcer disease (PUD); however recent cases have reported other causes including Eosinophilic Gastroenteritis (EGE), Brunner’s Gland Hyperplasia (BGH) and Pancreatic Heterotopia (PH). We present an unusual case of a 31 year old male patient with severe gastric outlet obstruction requiring surgical intervention caused by all three pathologies in unison – EGE, BGH and PH. The patient underwent surgical resection with distal gastrectomy and Billroth II reconstruction. Histology confirmed the three pathologies and post-operative recovery of the patient was uneventful.},
     year = {2017}
    }
    

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    AU  - Apurva Sharma
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    AB  - Gastric outlet obstruction is a common entity described with numerous benign and malignant causes. Historically, benign causes include Peptic Ulcer disease (PUD); however recent cases have reported other causes including Eosinophilic Gastroenteritis (EGE), Brunner’s Gland Hyperplasia (BGH) and Pancreatic Heterotopia (PH). We present an unusual case of a 31 year old male patient with severe gastric outlet obstruction requiring surgical intervention caused by all three pathologies in unison – EGE, BGH and PH. The patient underwent surgical resection with distal gastrectomy and Billroth II reconstruction. Histology confirmed the three pathologies and post-operative recovery of the patient was uneventful.
    VL  - 5
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Author Information
  • Department of Medicine, Saint Peters University Hospital, New Brunswick, USA

  • Department of Medicine, Saint Peters University Hospital, New Brunswick, USA

  • Department of Medicine, Division Gastroenterology and Hepatology, Rutgers Medical School Robert Wood Johnson, New Brunswick, USA

  • Department of Pathology, Saint Peters University Hospital, New Brunswick, USA

  • Department of Medicine, Division of Gastroenterology and Hepatology, Saint Peters University Hospital, New Brunswick, USA

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