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Zollinger-Ellison Syndrome

 Syn. Gastrinoma syndrome , ZES , Excessive gastrin secretion

Signs & Symptoms

 Develop peptic ulcers
Note: due to Hypergastrinemia
Ref: Uptodate [ Clinical manifestations and diagnosis of Zollinger-Ellison syndrome (gastrinoma)] Harrison [ 607] Harrison [ 607] Cecil [ 413]
Ulcers presenting with frank complications
Note: bleeding, obstruction, and perforation
Ref: Harrison [ 2238]
Mild esophagitis
Ref: Harrison [ 2238] Cecil [ 413]
Ulcers in absence of NSAID ingestion
Ref: Harrison [ 2238] Cecil [ 414]

Physical Examination

 Chronic unexplained diarrhea
Ref: Harrison [ 607] Cecil [ 1190]

Lab / Serology

 Elevated Fasting serum gastrin concentration
Note: upper limit of normal for serum gastrin is 110 pg/mL
Ref: Uptodate [ Clinical manifestations and diagnosis of Zollinger-Ellison syndrome (gastrinoma)] Harrison [ 2748] Cecil [ 413]
Increased basal gastric acid secretion
Ref: Harrison [ 2748] Harrison [ 607] Cecil [ 1175]
Peptic ulcer without Helicobacter pylori
Ref: Harrison [ 2238] Harrison [ 607] Cecil [ 1176]

Imagin Study

 Endoscopy reveal Prominent gastric folds
Ref: Uptodate [ Clinical manifestations and diagnosis of Zollinger-Ellison syndrome (gastrinoma)] Harrison [ 607]
Ulcers with obstruction
Ref: Harrison [ 2238]
Ulcer recurrence after acid-reducing surgery
Ref: Harrison [ 2238]

Complication

Risk Factors

Cause

Other