Gastrinoma (Zollinger-Ellison Syndrome)

Question 1

Gastrinoma (Zollinger-Ellison Syndrome) prevalence

Answer 1

Less than 1% of those with ulcer disease have a gastrinoma.

Question 2

Gastrinoma (Zollinger-Ellison Syndrome) Cx Fx

Answer 2

diarrhea (because acid inactivates lipase.) + epigastric pain?

Question 3

Mention 4 characteristics about Gastrinoma’s (Zollinger-Ellison Syndrome) Ulcers [morphologic or pathophysiological]

Answer 3

• Large (>1–2 cm)
• Recurrent after Helicobacter eradication
• Distal in the duodenum
• Multiple

Question 4

Gastrinoma (Zollinger-Ellison Syndrome) initial dx

Answer 4

1.- endoscopy confirms the presence of an ulcer

Question 5

Gastrinoma (Zollinger-Ellison Syndrome) most accurate test:

Answer 5

-High gastrin levels (>250 but especially >1600) off antisecretory therapy (PPIs or H2 blockers) with
high gastric acidity.
- High gastrin levels despite a high gastric acid output
- Persistent high gastrin levels despite injecting secretin

Question 6

Hypercalcemia is the clue for?

Answer 6

multiple endocrine neoplasia from hyperparathyroidism.

Question 7

Gastrinoma (Zollinger-Ellison Syndrome) next step after Dx

Answer 7

CT and MRI of the abdomen have poor sensitivity but are done first. So if they are normal:
**
Somatostatin receptor scintigraphy (nuclear octreotide scan) +
endoscopic ultrasound** to exclude metastatic disease.

Question 8

Gastrinoma (Zollinger-Ellison Syndrome) Tx

Answer 8

Local disease is removed surgically. Metastatic disease is unresectable and is
treated with lifelong PPIs to block acid production.

he is usually benign tho increases risk od gastric CA