Brunner's glands (or duodenal glands) are compound tubular

submucosa The submucosa (or tela submucosa) is a thin layer of tissue in various organs of the gastrointestinal, respiratory, and genitourinary tracts. It is the layer of dense irregular connective tissue that supports the mucosa (mucous membrane) and j ...

gland In animals, a gland is a group of cells in an animal's body that synthesizes substances (such as hormones) for release into the bloodstream (endocrine gland) or into cavities inside the body or its outer surface (exocrine gland). Structure De ...

s found in that portion of the

duodenum The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear, and the terms anterior intestine or proximal intestine m ...

which is above the hepatopancreatic sphincter (i.e sphincter of Oddi). It also contains submucosa which creates special glands. The main function of these glands is to produce a mucus-rich alkaline secretion i.e. mucous (containing

bicarbonate In inorganic chemistry, bicarbonate (IUPAC-recommended nomenclature: hydrogencarbonate) is an intermediate form in the deprotonation of carbonic acid. It is a polyatomic anion with the chemical formula . Bicarbonate serves a crucial biochemi ...

) in order to: * protect the duodenum from the acidic content of

chyme Chyme or chymus (; from Greek χυμός ''khymos'', "juice") is the semi-fluid mass of partly digested food that is expelled by a person's stomach, through the pyloric valve, into the duodenum stomach The stomach is a muscular, hollow organ in the gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach i ...

); * provide an alkaline condition for the intestinal enzymes to be active, thus enabling absorption to take place; * lubricate the intestinal walls. * They also secrete

epidermal growth factor Epidermal growth factor (EGF) is a protein that stimulates cell growth and differentiation by binding to its receptor, EGFR. Human EGF is 6-k Da and has 53 amino acid residues and three intramolecular disulfide bonds. EGF was originally de ...

, which inhibits parietal and

chief cell In human anatomy, there are three types of chief cells, the gastric chief cell, the parathyroid chief cell, and the type 1 chief cells found in the carotid body. Cell types The gastric chief cell (also known as a zymogenic cell or peptic cell) i ...

s of the stomach from secreting acid and their digestive enzymes. This is another form of protection for the duodenum. They are the distinguishing feature of the duodenum, and are named for the

Swiss Swiss may refer to: * the adjectival form of Switzerland *Swiss people Places * Swiss, Missouri *Swiss, North Carolina * Swiss, West Virginia *Swiss, Wisconsin Other uses * Swiss-system tournament, in various games and sports * Swiss Internation ...

physician who first described them,

Johann Conrad Brunner Johann Conrad Brunner (16 January 1653 – 2 October 1727) was a Swiss anatomist, especially cited for his work on the pancreas and duodenum. Life Brunner was born in Diessenhofen, and studied medicine in Schaffhausen, Strasbourg, Amsterd ...

Structure

Histology

The duodenum can be distinguished from the

jejunum The jejunum is the second part of the small intestine in humans and most higher vertebrates, including mammals, reptiles, and birds. Its lining is specialised for the absorption by enterocytes of small nutrient molecules which have been previou ...

and

ileum The ileum () is the final section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms posterior intestine or distal intestine m ...

by the presence of Brunner's glands in the submucosa.

Function

The Brunner glands, which empty into the

intestinal glands In histology, an intestinal gland (also crypt of Lieberkühn and intestinal crypt) is a gland found in between villi in the intestinal epithelium lining of the small intestine and large intestine (or colon). The glands and intestinal villi are co ...

, secrete an alkaline fluid composed of

mucin Mucins () are a family of high molecular weight, heavily glycosylated proteins (glycoconjugates) produced by epithelial tissues in most animals. Mucins' key characteristic is their ability to form gels; therefore they are a key component in most ...

, 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 Pepsin is an endopeptidase that breaks down proteins into smaller peptides. It is produced in the gastric chief cells of the stomach lining and is one of the main digestive enzymes in the digestive systems of humans and many other animals, ...

and

urogastrone Epidermal growth factor (EGF) is a protein that stimulates cell growth and differentiation by binding to its receptor, EGFR. Human EGF is 6-k Da and has 53 amino acid residues and three intramolecular disulfide bonds. EGF was originally descr ...

, which inhibit gastric acid secretion.

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

hamartoma A hamartoma is a mostly benign, local malformation of cells that resembles a neoplasm of local tissue but is usually due to an overgrowth of multiple aberrant cells, with a basis in a systemic genetic condition, rather than a growth descended f ...

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

References

External links