Name
GASTRINOMA ( ZOLLINGER-ELLISON SYNDROME )
DESCRIPTION
DETAIL
D.D. : ( CONDITIONS WITH HYPERGASTRINEMIA ) - RETAINED ANTRUM SYNDROME - H. PYLORI INFECTION - ANTRAL G CELL HYPERPLASIA / HYPERFUNCTION - GASTRIC OUTLET OBSTRUCTION - RENAL FAILURE ( RARELY ) - OTHERS LESS COMMON LIKE DIABETES , RHEUMATOID ARTHRITIS, VITILIGO, PHEOCHROMOCYTOMAOTHER TESTS : * GASTRIC ACID ANALYSIS - HIGH GASTRIC ACIDITY ( PH<3.0 ) * FASTING GASTRIN LEVELS , NORMAL < 150 PG/ML , > 150 TO 200 PG / ML ( OR >1000 NG/ L ; 10 TIMES NORMAL ) IS DIAGNOSTIC * BASAL GASTRIC ACID OUTPUT( HYPERCHLORHYDRIA ) - IN > 80% BAO IS ELEVATED ( 15 MEQ / H ) . * SECRETIN PROVOCATION TEST - POSITIVE IN > 80% ( >200 NG/L INCREASE IN SERUM GASTRIN LEVEL WITHIN 15 MTS OF IV SECRETIN) * ULTRA SOUND ABDOMEN, CT ABDOMEN, CELIAC ANGIOGRAPHY, AORTOGRAPHY ARE FREQUENTLY INSENSITIVE & MAY LOCALIZE ABOUT 60% OF GASTRINOMAS. * ENDOSCOPIC ULTRA SOUND OR INTRAOPERATIVE ULTRA SOUND * TRANSHEPATIC PORTAL VENOUS SAMPLE MAY LOCALIZE OCCULT TUMORS. * LOCALIZATION MAY BE DONE BY COMPARISION OF GASTRIN LEVELS IN THE RT. HEPATIC VEIN FOLLOWING SELECTIVE INFUSION OF THE INTRAPANCREATIC ARTRIES WITH SECRETIN.
TYPENOTES
RELATED DISEASE
Not Available Disease
DISEASE
INVESTIGATION
COMPLETE BLOOD COUNT, ENDOSCOPY UPPER G.I.