Prevalence of Duodenum Brunner Gland Crush Artifact: A Retrospective Study

Abstract

Purpose: The overall purpose of this study is to raise the awareness of the Bruner gland crush artifact, which is a less known entity. Specifically, this study investigates the relationship between the severity of crush artifact and patient characteristics such as age, gender, and pathological diagnosis. Materials and Methods: Duodenum endoscopic biopsies of patients who presented to the pathology laboratory of the Selcuk University Medical Faculty between January 2019 and January 2020 were retrospectively examined. The data source is patients' slides possessing Hematoxylin-eosin and histochemical PAS stains from biopsy materials. The patients are grouped into several classes according to the crush artifact's severity and location. Chi-square was used in the comparison of categorical variables. Results: Crushing artifacts were found in 91 (71%) patients. Classification results show that out of 91 (71%) cases, 64 cases (50%) are mild, 20 cases (16%) are moderate, and 7 cases (5%) are severe according to the amount of crush artifact. Also, 28 cases (21%) are located in the mucosa, 14 cases (11%) in the submucosa, and 15 cases (12%) are in the outer area. There was no statistically significant relationship between the amount of crush artifact and age, gender, and pathological diagnosis. Conclusion: Although it is not a pathological finding, Brunner gland crush artifact can be morphologically confused with various diseases such as neoplasms and infectious diseases. The study provides valuable insight regarding the Brunner gland crush artifact to prevent unnecessary procedures and, more importantly, misdiagnosis and unnecessary treatment.

Keywords

• duodenum
• brunner glands
• artifacts
• endoscopy