Radioisotope Scan—A Possible Aid in Differentiating Retained Gastric Antrum from Zollinger-Ellison Syndrome in Patients with Recurrent Peptic Ulcer

The odyssey of Zollinger-Ellison Syndrome is one of the most interesting in surgery. From the initial recognition of two patients with severe peptic ulcer disease in 1955 sprung an international dialogue on this unique disease culminating in discovery that gastrin was the hormone secreted by these pancreatic and duodenal tumors. The impact was the birth of a new area of science, “gastrointestinal endocrinology.” Initially, surgeons were challenged by the complexity of the patients and the need to perform total gastrectomy to prevent death from complications of the severe ulcer disease. Later, after the discovery of proton pump inhibitors, total gastrectomy was no longer needed and the surgeon could focus treatment on tumor removal added by radioimmunoassay for gastrin and new imaging modalities. Today, we recognize that all gastrinomas have malignant potential; early surgical removal can reduce the incidence of metastases and improve survival, independent of biochemical cure, in both sporadic and familial forms of the disease.

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Zollinger-Ellison syndrome. Case report

Case reports ◽

10.15446/cr.v5n1.71686 ◽

2019 ◽

Vol 5 (1) ◽

pp. 28-35

Author(s):

Juan Felipe Rivillas-Reyes ◽

Juan Leonel Castro-Avendaño ◽

Héctor Fabián Martínez-Muñoz

Keyword(s):

Peptic Ulcer ◽

Epigastric Pain ◽

Perforated Peptic Ulcer ◽

Whipple Procedure ◽

Ulcer Disease ◽

Zollinger Ellison Syndrome ◽

Standard Management ◽

Effective Option ◽

Low Incidence ◽

Emergency Surgical Intervention

Introduction: The Zollinger-Ellison syndrome (ZES) is a pathology caused by a neuroendocrine tumor, usually located in the pancreas or the duodenum, which is characterized by elevated levels of gastrin, resulting in an excessive production of gastric acid.Case presentation: A 42-year-old female patient with a history of longstanding peptic ulcer disease, who consulted due to persistent epigastric pain, melena and signs of peritoneal irritation. Perforated peptic ulcer was suspected, requiring emergency surgical intervention. Subsequently, a tumor lesion in the head of the pancreas was documented and managed with Whipple procedure. The pathology results reported a tumor suggestive of neuroendocrine neoplasm.Discussion: The Zollinger-Ellison syndrome occurs in 0.1 to 3 people per 1 000 000 inhabitants worldwide and is predominant in women between 20 and 50 years of age. It usually appears as a refractory acid-peptic disease or as a complication of gastric acid hypersecretion. Medical therapy is the standard management, being proton pump inhibitors (PPI) the most effective option. Surgery is recommended for sporadic ZES.Conclusions: ZES has a low incidence rate. It is rarely considered in the differential diagnosis of chronic epigastric pain and high clinical suspicion is required to achieve adequate management. This article is highly relevant as it presents a confirmed clinical case of ZES in Colombia, highlighting the importance of producing local scientific literature to improve the diagnosis and treatment of this pathology.

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Octreotide: stops bleeding from a peptic ulcer in Zollinger-Ellison syndrome

InPharma ◽

10.1007/bf03313510 ◽

1985 ◽

Vol 516 (1) ◽

pp. 5-5

Keyword(s):

Peptic Ulcer ◽

Zollinger Ellison Syndrome

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POSTOPERATIVE RECURRENT PEPTIC ULCER: THE SIGNIFICANCE OF THE ZOLLINGER‐ELLISON SYNDROME

The Medical Journal of Australia ◽

10.5694/j.1326-5377.1977.tb114567.x ◽

1977 ◽

Vol 2 (12) ◽

pp. 389-392 ◽

Cited By ~ 3

Author(s):

R. J. Lusby ◽

D. J. Byrnes ◽

T. B. Hugh

Keyword(s):

Peptic Ulcer ◽

Zollinger Ellison Syndrome

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Hypergastrinaemia Due to an Excluded Gastric Antrum: A Proposed Method for Differentiation from the Zollinger-Ellison Syndrome

Australian and New Zealand Journal of Medicine ◽

10.1111/j.1445-5994.1972.tb03073.x ◽

1972 ◽

Vol 2 (3) ◽

pp. 266-271 ◽

Cited By ~ 50

Author(s):

M. G. Korman ◽

D. F. Scott ◽

J. Hansky ◽

H. Wilson

Keyword(s):

Gastric Antrum ◽

Zollinger Ellison Syndrome

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The Use and Abuse of Histamine H2-Receptor Antagonists

Journal of The Royal Naval Medical Service ◽

10.1136/jrnms-63-9 ◽

1977 ◽

Vol 63 (1) ◽

pp. 9-14

Author(s):

G. J. Milton-Thompson

Keyword(s):

Peptic Ulcer ◽

Gastrointestinal Bleeding ◽

Medical Management ◽

H2 Receptor Antagonists ◽

Histamine H2 Receptor ◽

Ulcer Disease ◽

Zollinger Ellison Syndrome ◽

H2 Receptors ◽

Precise Diagnosis ◽

Stimulation Of

AbstractThe development of a new group of drugs blocking the histamine H2-receptors involved in the stimulation of gastric acid secretion is described. The indications for their use in peptic ulcer disease, reflux oesophagitis, acute gastrointestinal bleeding and the Zollinger-Ellison syndrome are considered but the need for precise diagnosis before treatment is emphasised. It is likely that these drugs will greatly alter the medical management of these conditions.

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