Brunner's glands

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Brunner's glands
Gray1058.png
Section of duodenum. (Duodenal glands in submucosa are labeled at right, fourth from the top.)
Details
System Digestive system
Location Duodenum
Identifiers
Latin glandulae duodenales
MeSH D002011
TA98 A05.6.02.017
TA2 2957
FMA 71622
Anatomical terms of microanatomy

Brunner's glands (or duodenal glands) are compound tubuloalveolar submucosal glands found in that portion of the duodenum proximal to the hepatopancreatic sphincter (i.e sphincter of Oddi).[ citation needed ]

Contents

Their main function is to secrete alkaline (bicarbonate-containing) mucous in order to:[ citation needed ]

They are the distinguishing feature of the duodenum, and are named for the Swiss physician who first described them, Johann Conrad Brunner.[ citation needed ]

Human Brunner's gland Duodenum-brunner's glands.JPG
Human Brunner's gland

Structure

Duodenal glands are situated within the mucosa and submucosa of the duodenum. They most abundant near the pylorus, growing shorter and more sparse distally towards the terminal portion of the duodenum. [1]

The duodenum can be distinguished from the jejunum and ileum by the presence of Brunner's glands in the submucosa.[ citation needed ]

Histology

Their excretory cannals are tortuous, opening at the bases of the villi. [1]

Two forms of duodenal glands are distinguished: the external group (which are more voluminous and extend into the duodenal submucosa), and the internal group (which are smaller and are situated within the duodenal mucosa). [1]

Function

They also secrete epidermal growth factor, which inhibits parietal and chief cells of the stomach from secreting acid and their digestive enzymes. [2] [ citation needed ] This is another form of protection for the duodenum.[ citation needed ]

Function

The Brunner glands, which empty into the intestinal glands, secrete an alkaline fluid composed of mucin, which exerts a physiologic anti-acid function by coating the duodenal epithelium, therefore protecting it from the acid chyme of the stomach. Furthermore, in response to the presence of acid in the duodenum, these glands secrete pepsinogen and urogastrone, which inhibit gastric acid secretion.[ citation needed ]

Clinical significance

Hyperplasia of Brunner glands with a lesion greater than 1 cm was initially described as a Brunner gland adenoma. Several features of these lesions favor their designation as hamartomas, including the lack of encapsulation; the mixture of acini, smooth muscles, adipose tissue, Paneth cells, and mucosal glands; and the lack of any cell atypia. These hamartomas are rare, with approximately 150 cases described in the literature. It is estimated that they represent approximately 5–10% of benign duodenal tumors. They are variable in size, typically 1–3 cm, with only a few reported cases of lesions larger than 5 cm.[ citation needed ]

Most patients with Brunner gland hamartomas are asymptomatic or have nonspecific complaints such as nausea, bloating, or vague abdominal pain.[ citation needed ]

Most reports in the literature describe local surgical resection of Brunner gland hamartoma via duodenotomy. Increasingly, successful endoscopic resection has been reported and is primarily used for pedunculated Brunner gland hamartomas. The endoscopic approach in selective cases appears to be safe, less invasive, and less costly.[ citation needed ]

See also

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References

  1. 1 2 3 "Dictionnaire médical de l'Académie de Médecine". www.academie-medecine.fr. Retrieved 2023-11-10.
  2. Gregory, H.; Preston, B. M. (1977-01-01). "The primary structure of human urogastrone". International Journal of Peptide and Protein Research. 9 (2): 107–118. doi:10.1111/j.1399-3011.1977.tb03470.x. ISSN   0367-8377. PMID   300079.