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Zollinger-Ellison syndrome: pathogenesis, diagnosis, and management.
Am J Gastroenterol. 1997 Apr; 92(4 Suppl):44S-48S; discussion 49S-50S.AJ

Abstract

Zollinger-Ellison syndrome (ZES) involves hypergastrinemia produced by gastrin-secreting tumor(s) of the pancreas or duodenum. Estimated to occur in 0.1-3 per million of the United States' population, the actual prevalence may be higher because ZES is often undetected with routine testing. ZES should be suspected in patients who present with persistent or complex duodenal or postsurgical ulcer, especially if accompanied by esophagitis, diarrhea, weight loss, and/or liver metastases. Twenty percent of ZES patients have multiple endocrine neoplasia type I, some of whom may also have elevated levels of serum calcium and a family history of ZES. Diagnostic tests include fasting serum gastrin concentration, gastric secretion analysis, with, if necessary, secretin stimulation of serum gastrin. Complete surgical tumorectomy for cure is impossible in as many as 70-90% of patients with ZES, who then require long-term medical therapy to reduce acid exposure. Basal acid output needs to be maintained at < 5 mEq/h for uncomplicated ZES and at < 1-2 mEq/h for complicated ZES or postgastrectomy. Proton pump inhibitors (omeprazole, lansoprazole) with careful clinical monitoring provide safe and effective acid control in patients with ZES.

Authors+Show Affiliations

Department of Medicine, University of Alabama School of Medicine, Birmingham 35294, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

9127626

Citation

Hirschowitz, B I.. "Zollinger-Ellison Syndrome: Pathogenesis, Diagnosis, and Management." The American Journal of Gastroenterology, vol. 92, no. 4 Suppl, 1997, 44S-48S; discussion 49S-50S.
Hirschowitz BI. Zollinger-Ellison syndrome: pathogenesis, diagnosis, and management. Am J Gastroenterol. 1997;92(4 Suppl):44S-48S; discussion 49S-50S.
Hirschowitz, B. I. (1997). Zollinger-Ellison syndrome: pathogenesis, diagnosis, and management. The American Journal of Gastroenterology, 92(4 Suppl), 44S-48S; discussion 49S-50S.
Hirschowitz BI. Zollinger-Ellison Syndrome: Pathogenesis, Diagnosis, and Management. Am J Gastroenterol. 1997;92(4 Suppl):44S-48S; discussion 49S-50S. PubMed PMID: 9127626.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Zollinger-Ellison syndrome: pathogenesis, diagnosis, and management. A1 - Hirschowitz,B I, PY - 1997/4/1/pubmed PY - 1997/4/1/medline PY - 1997/4/1/entrez SP - 44S-48S; discussion 49S-50S JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 92 IS - 4 Suppl N2 - Zollinger-Ellison syndrome (ZES) involves hypergastrinemia produced by gastrin-secreting tumor(s) of the pancreas or duodenum. Estimated to occur in 0.1-3 per million of the United States' population, the actual prevalence may be higher because ZES is often undetected with routine testing. ZES should be suspected in patients who present with persistent or complex duodenal or postsurgical ulcer, especially if accompanied by esophagitis, diarrhea, weight loss, and/or liver metastases. Twenty percent of ZES patients have multiple endocrine neoplasia type I, some of whom may also have elevated levels of serum calcium and a family history of ZES. Diagnostic tests include fasting serum gastrin concentration, gastric secretion analysis, with, if necessary, secretin stimulation of serum gastrin. Complete surgical tumorectomy for cure is impossible in as many as 70-90% of patients with ZES, who then require long-term medical therapy to reduce acid exposure. Basal acid output needs to be maintained at < 5 mEq/h for uncomplicated ZES and at < 1-2 mEq/h for complicated ZES or postgastrectomy. Proton pump inhibitors (omeprazole, lansoprazole) with careful clinical monitoring provide safe and effective acid control in patients with ZES. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/9127626/Zollinger_Ellison_syndrome:_pathogenesis_diagnosis_and_management_ L2 - http://www.diseaseinfosearch.org/result/7600 DB - PRIME DP - Unbound Medicine ER -