Condition Info - BotMed Application

ConditionName

Gastrinoma (Zollinger-Ellison Syndrome)

ConditionDescription

Refractory PUD

Symptoms

Abdominal pain;
Nausea; 
Vomiting;
Diarrhea; 
Anemia;
Heme-positive stools;
Steatorrhea;
Indigestion;
Heartburn
Bloating;
Weight loss;
Poor appetite;

PhysicalFindings

ClinicalTests

Serum gastrin;
CT, scintigraphy, or positron emission tomography (PET) to localize;

RiskFactors

 have a blood relative with MEN 1

IsRedFlag

IsNPLEX

Consequence

Five- and 10-year survival are > 90% when an isolated tumor is removed surgically vs 43% at 5 years and 25% at 10 years with incomplete removal.

ProgressionFromCondition

TreatmentOptions

Endoscopy;
Large ulcers >1cm;
Multiple;
Past 3ed portion of duodenum;

Provocation test: 
Found high gastrin even after PPI/H2 therapy (fasting);

High gastrin after injecting secretin – most accurate;

CT or MRI;
Surgery;

PharmOptions

Life time PPI or H2 antagonist

WebLink

https://www.merckmanuals.com/en-ca/professional/gastrointestinal-disorders/tumors-of-the-gastrointestinal-tract/gastrinoma