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Zollinger-Ellison syndrome (complications (abdominal ulceration,…
Zollinger-Ellison syndrome
aetiology
non-beta cell, gastrin-secreting tumour of the pancreas
MEN1
pathophysiology
stimulates acid-secreting cells of the stomach to maximal activity --> mucosal ulceration
incidence
M:F 1.3:1
mean age onset 43y
rare
prognosis
excellent if no metastatic disease
complications
abdominal ulceration
oesophageal stricture
bowel obstruction
GI bleeding
gastric carcinoids
clinical
history
abdominal pain
upper abdo
mimicing that of peptic ulcer disease
diarrhoea
heart burn
nausea
vomitting
GI bleeding
weight loss
examination
pale
jaundice
epigastric tenderness
dental erosions
hepatomegaly
diagnosis
fasting serum gastrin levels
ancillary
sCa
gastric acid secretory tests
somastostatin receptor scintigraphy
treatment
medical
PPI
H2 receptor blockers
surgery
surgical resection