ZES

Question 1

What is the clinical manifestations of ZES?

Answer 1

🟡 peptic ulcer 90% maybe indistinguishable from common PUD
🟢 diarrhea 50% due to volume overload and damage to intestinal epithelium by acid

Question 2

What are the clinical situations that should create suspicion of gastrinoma?

Answer 2

1-Ulcers in and usual locations, such as second part of the duodenum and beyond
2-ulcers refractory to standard medical therapy
3-ulcer recurrence after acid reducing surgery
4-ulcers, presenting with complications( bleeding, obstruction and perforation )