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Chapter 4 (page 19)
This may be of some importance in transpyloric prolapse of gastric mucosa
(Chap. 38). It probably also accounts for the fact that normally duodenal mucosal folds
are smaller, and less mobile, than mucosal folds of the pyloric sphincteric cylinder.
Brunner's glands have been shown to become hyperplastic in duodenal ulceration; this
was considered to be a defense mechanism against digestion by acid gastric juice.
In a few cases of pyloric adenocarcinoma, where extension into the duodenum had
occurred, we have noted that Brunner's glands were not infiltrated (Chap. 33). The
question arises whether this signifies that Brunner's glands, by virtue of their secretions
or some other mechanism, act as a biological or anatomical barrier preventing further
spread of gastric carcinoma down the duodenum; this aspect will be discussed in more
detail in Chapter 33.
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