Klimko Artsiom, Plotogea Oana, Constantinescu Alexandru, Constantinescu Gabriel
Division of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU.
Department of Gastroenterology, Carol Davila University of Medicine and Pharmacy, Clinical Emergency Hospital of Bucharest, Bucharest, ROU.
Cureus. 2020 Jun 6;12(6):e8471. doi: 10.7759/cureus.8471.
We present a case of a 60-year-old male diagnosed with Zollinger-Ellison syndrome (ZES) after a protracted multicentric workup for chronic diarrhea and unexplained weight loss. ZES is intrinsically difficult to diagnose due to nonspecific symptoms, which are mimicked by other more frequent pathologies, such as peptic ulcer disease secondary to Helicobacter pylori or nonsteroidal anti-inflammatory drugs. The diagnostic challenge can be further complicated by patient noncompliance, resulting in delayed management and unnecessary health care. In our case report, the patient did not adhere to the care plan preceding endoscopy and failed to maintain communication with the treating doctor. As a result, crucial information was missing, and establishing the diagnosis of ZES took six months. Delay in appropriate management also contributed to poor disease course, heavy necrotic ulceration of the duodenum and proximal jejunum that was discovered on repeat endoscopy.
我们报告一例60岁男性患者，该患者因慢性腹泻和不明原因体重减轻接受了长时间的多中心检查后，被诊断为佐林格-埃利森综合征（ZES）。由于ZES的症状不具特异性，易被其他更常见的病症（如幽门螺杆菌或非甾体抗炎药继发的消化性溃疡病）所模仿，因此其本质上难以诊断。患者不配合会使诊断挑战进一步复杂化，导致治疗延迟和不必要的医疗保健。在我们的病例报告中，患者在内镜检查前未遵守护理计划，也未能与主治医生保持沟通。结果，关键信息缺失，确诊ZES花费了六个月时间。适当治疗的延迟也导致了病情发展不佳，再次内镜检查时发现十二指肠和空肠近端出现严重坏死性溃疡。
