Aamar Ali, Madhani Kamraan, Virk Hafeezulhassan, Butt Zeeshan
Internal Medicine Residency Program, Yale-Waterbury, Waterbury, CT, USA.
Internal Medicine Residency Program, Mount Sinai St. Luke, New York, NY, USA.
Gastroenterology Res. 2016 Dec;9(6):103-104. doi: 10.14740/gr734w. Epub 2016 Dec 23.
Zollinger-Ellison syndrome (ZES) is caused by hypersecretion of gastrin from duodenal or pancreatic gastrinomas. We report a case of a 57-year-old female who presented with chronic diarrhea. CT abdomen showed multiple liver masses. Liver biopsy suggested metastatic well-differentiated neuroendocrine tumor. Serum gastrin level was markedly elevated. MRI abdomen, somatostatin receptor scintigraphy and endoscopic ultrasound failed to reveal primary site of the tumor. Upper gastrointestinal endoscopy showed hyperplastic gastric folds and multiple duodenal ulcers consistent with ZES. Patient was started on high-dose omeprazole and octreotide resulting in improvement in diarrhea.
佐林格-埃利森综合征（ZES）由十二指肠或胰腺胃泌素瘤分泌过多胃泌素引起。我们报告一例57岁女性患者，表现为慢性腹泻。腹部CT显示肝脏有多个肿块。肝脏活检提示为转移性高分化神经内分泌肿瘤。血清胃泌素水平显著升高。腹部MRI、生长抑素受体闪烁扫描和内镜超声均未能发现肿瘤的原发部位。上消化道内镜检查显示胃皱襞增生和多个十二指肠溃疡，符合佐林格-埃利森综合征。患者开始使用大剂量奥美拉唑和奥曲肽治疗，腹泻症状有所改善。
