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Relationship between diseases of the pancreas and hyperplasia of Brunner's glands

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Summary

Examination of 105 duodeno-pancreatectomy specimens showed that 75.7% of the cases of chronic pancreatitis (n = 74) manifested diffuse hyperplasia of Brunner's glands. In pancreatitis involving part of the pancreas in the presence of ducts of the embryonic type (n = 6), in segmental pancreatitis (n = 16), and in pancreatic cancer (n = 23), no significant difference in the thickness of the layer of Brunner's glands was found as compared with normal specimens.

There was no statistically significant correlation between the degree of hyperplasia of Brunner's glands and the degree of scarring of the exocrine pancreatic parenchyma. Nor was there any correlation between existence and extent of scarring of the duodenal wall, inflammatory infiltration of the duodenal mucosa, duration of disease, consumption of alcohol and history of gall stones and ulcers in patients with and without hyperplasia of Brunner's glands. Diffuse hyperplasia of the duodenal glands is probably an adaptive reaction to the exocrine insufficiency of the pancreas or the changes in gastric function (hyperacidity, accelerated emptying of the stomach) caused by chronic pancreatitis. A fact which supports this statement is that the inhibitor hormone urogastrone — an inhibitor of gastric acid secretion — is formed in Brunner's glands. The question is also discussed whether chronic pancreatitis and hyperplasia of Brunner's glands might not also develop simultaneously in the presence of disturbances of the gastrointestinal hormones, themselves either primary or due to alcohol consumption.

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References

  • Babkin B (1928) Die äußere Sekretion der Verdauungsdrüsen. In: Gildemeister M, Goldschmidt R, Neuberg L, Parnas J, Ruhland W (Hrsg) Monographien aus dem Gesamtgebiet der Physiologie der Pflanzen und Tiere. Bd 15, Verlag Julius Springer, Berlin

    Google Scholar 

  • Brunner JC (1683) Experimenta nova circa pancreas, accedit diatribe de lympha et gemino pancreatis usu. Amsterdam

  • Brunner JC (1687) De glandulis in duodeni intestino homini detectis. Amsterdam

  • Brunner JC (1715) Glandulae duodeni seu pancreas secondarium. Frankfurt Heidelberg

  • Caspary WF, Winckler K, Lankisch RG, Creutzfeldt W (1975) Influence of exocrine and endocrine pancreatic function on intestinal border enzymatic activities. GUT 16:89–92

    Google Scholar 

  • Cruveilhier J (1835–1842) Anatomic Pathologique du corps humain. JB Balliere, Paris

    Google Scholar 

  • Davenport HW (1971) Physiologie der Verdauung. Schattauer Verlag, Stuttgart, New York, S. 188–190

    Google Scholar 

  • Deren MD, Henry PD (1956) Adenoma of Brunner's glands. Ann Intern Med 44:180–187

    Google Scholar 

  • Dragstedt LR (1943) Some physiological problems in surgery of the pancreas. Ann Surg 118:576

    Google Scholar 

  • Dreiling DA, Nagavi MA (1969) Peptic ulcer diathesis in patients with chronic pancreatitis. Am J Gastroenterol 51:503

    Google Scholar 

  • Elman R, Hartmann AF (1931) Spontaneous peptic ulcers of duodenum after continued loss of total pancreatic juice. Arch Surg 23:1030–1041

    Google Scholar 

  • Epstein AA, Cole LJ (1954) Hyperplasia of Brunner's glands. J Can Assoc Radiol 5:43–45

    Google Scholar 

  • Erb WH, Johnson ThA (1940) Hyperplasia of Brunner's glands stimulating duodenal polyposis. Gastroenterology 11:740–745

    Google Scholar 

  • Feyrter F (1934) Über Wucherungen der Brunnerschen Drüsen. Virchows Arch [Pathol Anat] 293:509–526

    Google Scholar 

  • Fitzgerald O, Fitzgerald P, Fenelly J (1963) A clinical study of chronic pancreatitis. GUT 4:193

    Google Scholar 

  • Florey HW, Harding HE (1934) Further observations on the secretions of Brunner's glands. J Pathol Bacteriol 39:255–276

    Google Scholar 

  • Florey HW, Harding HE (1933) The functions of Brunner's glands and pyloric end of the stomach. J Path Bact 37:431–453

    Google Scholar 

  • Florey HW, Harding HE (1935) The nature of the hormone controlling Brunner's glands. Quart J Exp Physiol 25:329–339

    Google Scholar 

  • Goldberg MJ (1959) Hyperplasia of Brunner's glands. Br J Radiol 32:241–243

    Google Scholar 

  • Goldman RL (1963) Hamartomatous polyp of Brunner's glands. Gastroenterology 44:57

    Google Scholar 

  • Greenlees HB, Nelsen TS, Dragstedt LR (1959) The effect of pancreatic fistula on gastric secretion. Arch Surg 79:156–160

    Google Scholar 

  • Griffith CA, Harkins HN (1956) The role of Brunner's glands in the intrinsic resistence of the duodenum to acid-peptic digestion. Ann Surg 143:160–172

    Google Scholar 

  • Grossman MJ (1958) The glands of Brunner. Physiol Rev 38:675–690

    Google Scholar 

  • Günther H (1948) Anomaliekomplex und Zufallssyndromie. Zbl Pathol 84:6

    Google Scholar 

  • Hanssen LE, Hanssen KF, Myren, J (1977) Inhibition of secretion release and pancreatic secretion by Somatostatin infusion in man. Scand J Gastroenterol 9:391–394

    Google Scholar 

  • Harvey RF, Hartog M, Dowsett L, Read AE (1973) A Radioimmunassay for Cholecystokinin-Pancreocymin. Lancet 13:826–828

    Google Scholar 

  • Heitz Ph, Kasper M, van Noorden S, Polak JM, Gregory H, Pearse AGE (1978) Urogastron — anti-Ulkus Prinzip? Verh Dtsch Ges Pathol 62

  • Howard JM, Jordan GL (1960) Surgical diseases of the pancreas. Lippincott, Philadelphia

    Google Scholar 

  • Jirko P, Kudrmann J, Kocianova J, Maratka Z (1974) Hyperplasia of Brunner's glands. Czech Cs Gastroenterol Vyz 28:233

    Google Scholar 

  • Jones RS, Hall AD (1969) The effect of glucagon on Brunner's glands secretion in dogs. Proc Soc Exp Biol Med 132:1159–1161

    Google Scholar 

  • Kalk WJ, Vinik AI, Paul M, Leller P, Jackson WP (1976) Immunoreactive glucagon responses to intravenous Tolbutamide in chronic pancreatitis. Diabetes 24:851

    Google Scholar 

  • Kaplan EL, Dyson WL, Fitts WT (1968) Hyperplasia of Brunner's glands of the duodenum. Surg Gynecol Obstet 371–375

  • Kocianova J, Maratka Z, Kudrmann J, Prik F (1974) Hyperplasia of Brunner's glands. II Clinical and bioptic study. Czech Cs Gastroenterol Vyz 28/2:239–246

    Google Scholar 

  • Kraetz RE, Spiro HM (1965) Gastric secretion in chronic pancreatitis. Ann Intern Med 63:776–782

    Google Scholar 

  • Landboe-Christensen E (1944) The duodenal glands of Brunner in man, their distribution and quantity. An anatomical study. Acta Pathol Scand (Suppl) 5253:11–264

    Google Scholar 

  • Landor JH, Adams LA (1962) Pancreatic duct ligation and gastric secretion. Surg Forum 13:292

    Google Scholar 

  • Maratka Z, Kocianova J, Kudrmann J, Pirk F (1977) Hyperplasia of Brunner's glands, polypoid pattern and duodenitis. Hospital Bulovka 18081 Praha 8, CSSR

  • Pelletier MJ, Chavialle JA, Desos L, Kiriacos J, Lambert R (1976) Hydrocloric acid-induced secretion release and halflife of exogenous secretin in patients with chronic pancreatitis. Scand J Gastoenterol 11:14

    Google Scholar 

  • Petersen H, Solomon T. Grossman MJ (1976) Trophic effect of pentagastrin, cholecystokinin and secretin on the pancreas in rats. Scand J Gastroenterol 11:141

    Google Scholar 

  • Robertson HE (1941) The pathology of Brunner's glands. Arch Pathol 31:112–131

    Google Scholar 

  • Sarles H, Singer M, Sahel J (1978) Pathologische Anatomie, Pathogenese und Ätiologie der chronischen Pankreatitis. In: Sarles H. Singer M (ed) Akute und chronische Pankreatitis. Witzstrock-Verlag, Baden-Baden Köln New York

    Google Scholar 

  • Savioli G (1876) Contributione allo studio degli adenomi. L'Osservatore E. gazetta Medica di Torino 12:481

    Google Scholar 

  • Sonnenschein RR, Grossman MJ, Joy AC (1947) The humoral regulations of Brunner's glands. Acta Med Scand 296–307

  • Stening GF, Grossman MJ (1969) Hormonal control of Brunner's glands. Gastroenterology 56:1047–1052

    Google Scholar 

  • Tanaka S, Sakaguchy Y (1974) Pathohistologic studies on benign tumors or lesions resembling tumors of the duodenum. Stomach Intest 9/12:1591–1597

    Google Scholar 

  • Warren KW, Cattell RB (1959) Pancreatic surgery. N Engl J Med 261:280

    Google Scholar 

  • Wepfer: Zit bei Grossman MJ (1958) The glands of Brunner. Physiol Rev 38:675–690

    Google Scholar 

  • Wormsley KG (1970) Response to duodenal acidification in man. Effects on the gastric secretor response to pentagastrin. Scand J Gastroenterol 5:207–216

    Google Scholar 

  • Wormsley KG (1970) Response to duodenal acidification in man. Comparison with the effects to secretin and pancreocymin. Scand J Gastroenterol 5:353–360

    Google Scholar 

  • Wormsley KG (1978) Die Behandlung der kranken Bauchspeicheldrüse. In: Bartelheimer H, Classen M, Ossenberg FW (Hrsg) II. Hamburger Medizinisches Symposium. Thieme-Verlag, Stuttgart

    Google Scholar 

  • Wright RD, Jennings MA, Florey HW, Lium R (1939) The influence of nerves and drugs on secretion by the small intestine and an investigation of the enzymes in intestinal juice. Sir William Dumm School of Pathology, Oxford

    Google Scholar 

  • Wright RD, Jennings MA, Florey HW, Lium R (1940) The influence of nerves and drugs on the secretion by the small intestine and an investigation of the enzymes in intestinal juice. Quart J Exp Physiol: 73–120

Download references

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Stolte, M., Schwabe, H. & Prestele, H. Relationship between diseases of the pancreas and hyperplasia of Brunner's glands. Virchows Archiv [Pathol Anat] 394, 75–87 (1981). https://doi.org/10.1007/BF00431666

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