Zollinger-Ellison syndrome

Background

  • Also known as "S-E syndrome"
  • gastric neuroendocrine malignancy results in hypersecretion of hydrochloric acid by parietal cells
  • Associated with peptic ulcers and diarrhea
  • 60% malignant, only 20% resectable; 25% of gastrinoma patients have multiple endocrine neoplasia type I; >80% of gastrinomas found in gastrinoma triangle.

Clinical Features

  • Hematemesis
  • Chronic diarrhea
  • Steatorrhea
  • Postprandial abdominal pain
  • Nausea
  • Wheezes on auscultation
  • Evidence of malnourishment and decreased oral intake

Differential Diagnosis

Evaluation

Workup

Diagnosis

Management

  • Proton-Pump Inhibitors
  • Somatostatin analog (Octreotide) if no improvement
    • Direct inhibition of gastric secretion
  • Surgical resection

Disposition

See Also

External Links

References