Zollinger-Ellison syndrome: Difference between revisions

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	Zollinger-Ellison syndrome;
	Endoscopy image of multiple small ulcers in the distal duodenum in a patient with Zollinger-Ellison syndrome

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Latest revision as of 23:22, 26 September 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S [2] Mohamad Alkateb, MBBCh [3] Shadan Mehraban, M.D.[4]

Synonyms and keywords: ZE; Z-E syndrome; Pancreatic Ulcerogenic Tumor Syndrome; Excessive Gastrin Secretion; Gastrinoma; Pancreatic Ulcerogenic Tumor Syndrome; ZES.

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Zollinger-Ellison syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Treatment

Medical Therapy | Surgery | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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-'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
-{{GS}}
-{{Editor Join}}
 {{Infobox_Disease |
    Name           = {{PAGENAME}} |
    Image          = ZES endo.jpg |
    Caption        = Endoscopy image of multiple small [[ulcer]]s in the distal [[duodenum]] in a patient with Zollinger-Ellison syndrome |
-  DiseasesDB     = |
-  ICD10          = {{ICD10|E|16|4|e|15}} |
-  ICD9           = {{ICD9|251.5}} |
-  ICDO           = |
-  OMIM           = |
-  MedlinePlus    = 000325 |
-  eMedicineSubj  = med |
-  eMedicineTopic = 2437 |
-  eMedicine_mult = {{eMedicine2|ped|2472}} |
-  MeshID         = D015043 |
 }}
+__NOTOC__
 {{Zollinger-Ellison syndrome}}
+'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
+{{CMG}} {{AE}} {{ARK}} {{MJK}} {{S.M}}
-==Overview==
+{{SK}} ZE; Z-E syndrome; Pancreatic Ulcerogenic Tumor Syndrome; Excessive Gastrin Secretion; Gastrinoma; Pancreatic Ulcerogenic Tumor Syndrome; ZES.
-'''Zollinger-Ellison syndrome''' is a disorder where increased levels of the hormone [[gastrin]] are produced, causing the [[stomach]] to produce excess [[hydrochloric acid]]. Often, the cause is a tumor ([[gastrinoma]]) of the [[duodenum]] or [[pancreas]] producing the hormone [[gastrin]]. Gastrin then causes an excessive production of acid which can lead to peptic ulcers (in almost 95% of patients)
-Gastrin works on stomach [[parietal cell]]s causing them to [[Hydrogen potassium ATPase|secrete]] more [[hydrogen ion]]s into the stomach lumen. In addition, gastrin acts as a trophic factor for parietal cells, causing parietal cell hyperplasia. Thus, there is an increase in the number of acid secreting cells and each of these cells produces acid at a higher rate. The increase in acidity contributes to the development of [[peptic ulcer]]s in the stomach and duodenum.
+==[[Zollinger-Ellison syndrome overview|Overview]]==
-High acid levels lead to multiple [[ulcer]]s in the stomach and small bowel.
-Patients with Zollinger-Ellison syndrome may experience abdominal pain and [[diarrhea]]. The diagnosis is also suspected in patients without symptoms who have severe ulceration of the stomach and small bowel, especially if they fail to respond to treatment.
+==[[Zollinger-Ellison syndrome historical perspective|Historical Perspective]]==
-Gastrinomas may occur as single tumors or as multiple, small tumors. About one-half to two-thirds of single gastrinomas are [[malignant]] tumors that most commonly spread to the [[liver]] and [[lymph node]]s near the pancreas and small bowel. Nearly 25 percent of patients with gastrinomas have multiple tumors as part of a condition called [[multiple endocrine neoplasia]] type I (MEN I). MEN I patients have tumors in their [[pituitary gland]] and [[parathyroid gland]]s in addition to tumors of the pancreas.
+==[[Zollinger-Ellison syndrome pathophysiology|Pathophysiology]]==
-==Symptoms==
+==[[Zollinger-Ellison syndrome causes|Causes]]==
-*[[epigastric]] pain (stomachache)
-*vomiting blood ([[hematemesis]]) (occasional)
-*difficulty in eating
-*[[diarrhea]]
-*[[steatorrhea]]
-==Diagnosis==
+==[[Zollinger-Ellison syndrome differential diagnosis|Differentiating Zollinger-Ellison syndrome from other Diseases]]==
-The diagnosis of Zollinger-Ellison syndrome is made by several laboratory tests and imaging studies.
-Laboratory tests:
+==[[Zollinger-Ellison syndrome epidemiology and demographics|Epidemiology and Demographics]]==
-* [[secretin]] stimulation test, which measures [[gastrin]] levels in response to secretin
-* fasting gastrin levels
-* antral acidity
-==Therapy==
+==[[Zollinger-Ellison syndrome risk factors|Risk Factors]]==
-[[Proton pump inhibitor]]s (such as [[omeprazole]] and [[lansoprazole]]) and histamine [[H2-receptor antagonist]]s (such as [[famotidine]] and [[ranitidine]]) are used to slow down acid secretion. If possible the tumours should be surgically removed, or treated with [[chemotherapy]].
+==[[Zollinger-Ellison syndrome screening|Screening]]==
+==[[Zollinger-Ellison syndrome natural history|Natural History, Complications and Prognosis]]==
-[[Octreotide]] can be used to slow down acid secretion.
+==Diagnosis==
+[[Zollinger-Ellison syndrome history and symptoms|History and Symptoms]] | [[Zollinger-Ellison syndrome physical examination|Physical Examination]] | [[Zollinger-Ellison syndrome laboratory findings|Laboratory Findings]] | [[Zollinger-Ellison syndrome CT|CT]] | [[Zollinger-Ellison syndrome MRI|MRI]] | [[Zollinger-Ellison syndrome ultrasound|Ultrasound]] | [[Zollinger-Ellison syndrome other imaging findings|Other Imaging Findings]] | [[Zollinger-Ellison syndrome other diagnostic findings|Other Diagnostic Findings]]
-==History==
+==Treatment==
-The disease entity was first described in 1955 by its namesakes: Zollinger RM, Ellison EH. ''Primary peptic ulcerations of the jejunum associated with islet cell tumors of the pancreas.'' Ann Surg 1955;142:709-23. PMID 13259432.
+[[Zollinger-Ellison syndrome medical therapy|Medical Therapy]] | [[Zollinger-Ellison syndrome surgery|Surgery]] | [[Zollinger-Ellison syndrome cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Zollinger-Ellison syndrome future or investigational therapies|Future or Investigational Therapies]]
-==External links==
+==Case Studies==
-* [http://www.bidmc.org/YourHealth/ConditionsAZ.aspx?ChunkID=102706 Beth Israel Deaconess Medical Center: Zollinger-Ellison Syndrome]
+[[Zollinger-Ellison syndrome case study one|Case #1]]
 {{Endocrine pathology}}
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 [[Category:Endocrinology]]
 [[Category:Syndromes]]
+[[Category:Oncology]]
-[[de:Zollinger-Ellison-Syndrom]]
-[[es:Síndrome de Zollinger-Ellison]]
-[[fr:Syndrome de Zollinger-Ellison]]
-[[pl:Zespół Zollingera-Ellisona]]
-[[pt:Síndrome de Zollinger-Ellison]]
-[[ru:Синдром Золлингера — Эллисона]]
-[[sv:Zollinger-Ellisons syndrom]]
-[[th:โรคเนื้องอกที่เกิดจากการหลั่งกรดผิดปกติ]]
 {{WikiDoc Help Menu}}
 {{WikiDoc Sources}}
+ [[Category:Up-To-Date]]
+[[Category:Oncology]]
+[[Category:Medicine]]
+[[Category:Gastroenterology]]
+[[Category:Surgery]]

v t e Endocrine pathology: endocrine diseases (E00-35, 240-259)
Thyroid	Hypothyroidism (Iodine deficiency, Cretinism, Congenital hypothyroidism, Goitre, Myxedema) - Hyperthyroidism (Graves disease, Toxic multinodular goitre, Teratoma with thyroid tissue or Struma ovarii) - Thyroiditis (De Quervain's thyroiditis, Hashimoto's thyroiditis, Riedel's thyroiditis) - Euthyroid sick syndrome
Pancreas	Diabetes mellitus (type 1, type 2, coma, angiopathy, ketoacidosis, nephropathy, neuropathy, retinopathy) - Hypoglycemia - Hyperinsulinism - Zollinger-Ellison syndrome - insulin receptor (Rabson-Mendenhall syndrome)
Parathyroid	Hypoparathyroidism (Pseudohypoparathyroidism) - Hyperparathyroidism (Primary, Secondary, Tertiary)
Pituitary	Hyperpituitarism (Acromegaly, Hyperprolactinaemia, SIADH) - Hypopituitarism (Simmonds' disease / Sheehan's syndrome, Kallmann syndrome, Growth hormone deficiency, Diabetes insipidus) - Adiposogenital dystrophy - Empty sella syndrome - Hypophysitis
Adrenal	Cushing's syndrome (Nelson's syndrome, Pseudo-Cushing's syndrome) - CAH (Lipoid, 3β, 11β, 17α, 21α) - Hyperaldosteronism (Conn syndrome, Bartter syndrome) - Adrenal insufficiency (Addison's disease) - Hypoaldosteronism
Gonads	Ovarian dysfunction (Polycystic ovary syndrome, Premature ovarian failure) - Testicular dysfunction (5-alpha-reductase deficiency) - Testosterone biosynthesis (17-beta-hydroxysteroid dehydrogenase deficiency) - General (Hypogonadism, Delayed puberty, Precocious puberty)
Other	Androgen insensitivity syndrome - Autoimmune polyendocrine syndrome - Carcinoid syndrome - Gigantism - Short stature (Laron syndrome, Psychogenic dwarfism) - Multiple endocrine neoplasia (1, 2) - Progeria - Woodhouse-Sakati syndrome


Zollinger-Ellison syndrome
Endoscopy image of multiple small ulcers in the distal duodenum in a patient with Zollinger-Ellison syndrome

Zollinger-Ellison syndrome: Difference between revisions

Latest revision as of 23:22, 26 September 2021

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