A rare cause of the small bowel ulcers

Česká verze

Authors: Leksa V.; Kubát J.; Vyhnálek P.
Authors place of work: Interní oddělení, Nemocnice Pardubického kraje a. s., Pardubická nemocnice
Published in the journal: Gastroent Hepatol 2021; 75(1): 55-60
Category: Klinická a experimentální gastroenterologie: kazuistika
doi: https://doi.org/10.48095/ccgh202155

Summary

Zollinger-Ellison syndrome is a very rare disease characterized by increased production of gastric acid that leads to peptic ulcer disease and diarrhea. It is caused by disproportionate ectopic secretion of gastrin from the cells of the endocrine tumor of digestive system – gastrinoma. It occurs sporadically or as a part of multiple endocrine neoplasia type 1. The tumor is localized mostly in duodenum and pancreas. The treatment combines control of gastric acid secretion, nowadays mainly by proton pump inhibitors and the treatment of gastrinoma itself – surgical or oncological (chemotherapy, biological treatment). In our paper, we present a case of a middle-aged woman examined for abdominal pain and diarrhea. Her initial gastroscopy showed erosive duodenitis; we excluded the infectious etiology of the diarrhea. During the examination process, there were severe complications of peptic ulcer disease for which several surgeries were done. From all the laboratory results and imaging methods, the final diagnosis was made – Zollinger-Ellison syndrome due to gastrinoma of the tail of pancreas and the patient underwent surgery. Unfortunately, there was a progression of the disease in a short time that requested another oncological and surgical treatment.

Keywords:

Zollinger-Ellison syndrome – gastrin – gastrinoma – peptic ulcer – proton pump inhibitors – Somatostatin

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