Hyperplasia of Brunner's Glands.

Brunner's glands are rarely the seat of pathological change. Cases of solitary adenoma arising in the glands are reported (Jacobius, 1940; Cattell and Pyrtek, 1949; Culver and Caccese, 1957; Stephens and Harbrecht, 1958) and carcinoma has been noted on one occasion (Christie, 1953). In addition, it is known that diffuse hyperplasia, producing lobulated masses of glands, may occur; it is difficult to regard this change as a primary tumour of the glands and it seems more probable that it is a true hyperplasia in response to an increased stimulus of some sort. The diagnosis of hyperplasia is only made after barium meal (Dobek, 1961) and the significance of the characteristic radiological appearances is still debated. Feldman and Feldman (1958) note that, in many cases, the pathological changes are only discovered at operation or at necropsy in patients for whose vague abdominal symptoms no other satisfactory cause has been established. Three instances of young men with upper abdominal symptoms, in whose cases the typical radiological changes of hyperplasia of Brunner's glands have been observed, are reported.