PMC3217610_01
(a) Endoscopy showed 2 cm polypoid mass with rugal fold-like surface resembling stomach mucosal folds in proximal duodenum. (b) Upper GI series showed an oval lucent shadow (filling defect) in the duodenal bulb, close to the outlet of pylorus. (c) Abdominal CT scan with contrast showed entrapment of contrast in the stomach and duodenum at the level of second lumbar vertebra suggestive of a soft tissue mass or nonopaque particle. (d) Peach kernel found impacted in duodenum.
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fig1
Endoscopy showed edematous pylorus, and entering the bulb there was a 2 cm polypoid mass with rugal fold-like surface resembling stomach mucosal folds and ulcerative lesions in proximal duodenum (Figure 1). Upper GI series showed an oval lucent shadow (filling defect) in the duodenal bulb, close to the outlet of pylorus (Figure 1(b), arrow) suggestive of Brunner's gland hyperplasia/adenoma. Abdominal CT scan with contrast showed entrapment of contrast in the stomach and duodenum at the level of second lumbar vertebra suggestive of a soft tissue mass or nonopaque particle (Figure 1(c), arrow). Gross and microscopic pathology of the whole resected specimen was positive only for an ulcerative area in proximal bulb and interestingly an impacted peach kernel was found beside it (Figure 1(d)).