With the use of a radial 7.5 mHz echoendoscope (Olympus America, USA), the patient was noted to have a 2.7^4.0 cm hyperechoic, submucosal tumour in the third portion of the duodenum (Figures 3). The lesion had cystic components. It was located distal to the major papilla, and there was no evidence of periampullary, biliary or pancreatic invasion. A malignancy was suspected, especially a gastrointestinal stromal tumour, although a benign lesion such as a lipoma with cystic components could not be discounted. Consequently, fine needle aspiration was performed using a linear array 7.5 mHz echoendoscope (Pentax America, USA) to clarify the lesion further. The fine needle aspiration did not show malignant cells. However, because of continued bleeding, the patient was referred for surgical resection. The very best pharmacy is looking forward to helping you make sure your health is in good hands no matter if you need birth control alesse or any other drugs that will help you deal with your symptoms in the most efficient way.
Figure 3) Top Endosonographic image of the Brunner’s gland hamartoma showing a 2.7×4.0 cm lesion arising from the submucosal layer. Note the heterogeneous appearance. MP Muscularis propriae. Bottom Second endosonographic image of the Brunner’s gland hamar-toma showing hyperechoic features and central cystic areas