Ito Sunao, Ogawa Ryo, Komura Masayuki, Hayakawa Shunsuke, Okubo Tomotaka, Sagawa Hiroyuki, Tanaka Tatsuya, Mitsui Akira, Takahashi Satoru, Takiguchi Shuji
Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan.
Department of Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan.
J Surg Case Rep. 2023 Dec 16;2023(12):rjad679. doi: 10.1093/jscr/rjad679. eCollection 2023 Dec.
Gastrinomas are pancreatic or duodenal endocrine tumors that secrete excess gastrin, which causes gastroesophageal reflux disease, peptic ulcers, and chronic diarrhea. Due to the rarity of the disease, nonspecific symptoms, and the outstanding effect of proton pump inhibitors, diagnosing gastrinomas is difficult. Here, we present the case of a 58-year-old woman who had a duodenal gastrinoma that caused rare but critical events, including esophageal perforation, necrotizing esophagitis, and severe esophageal stricture. She presented with a non-malignant severe lower esophageal stricture, which was resistant to endoscopic dilatation. During esophagectomy, a duodenal mass was excised and diagnosed as gastrinoma. This was considered the main cause of all events. Gastrinomas are rarely encountered in clinical practice, but early diagnosis is necessary to avoid serious conditions. Therefore, whenever we encounter a patient with gastroesophageal reflux disease requiring long-term treatment or is refractory, we must not forget to screen for gastrinomas.
胃泌素瘤是胰腺或十二指肠内分泌肿瘤，可分泌过量胃泌素，导致胃食管反流病、消化性溃疡和慢性腹泻。由于该疾病罕见、症状不具特异性，且质子泵抑制剂效果显著，胃泌素瘤的诊断较为困难。在此，我们报告一例58岁女性病例，其患有十二指肠胃泌素瘤，引发了罕见但严重的事件，包括食管穿孔、坏死性食管炎和严重食管狭窄。她表现为非恶性的严重食管下段狭窄，对内镜扩张治疗无效。在食管切除术中，切除了十二指肠肿物，诊断为胃泌素瘤。这被认为是所有事件的主要原因。胃泌素瘤在临床实践中很少见，但早期诊断对于避免严重病情很有必要。因此，每当我们遇到需要长期治疗或难治性胃食管反流病患者时，绝不能忘记筛查胃泌素瘤。
