ZES

Question 1

Another name for Zollinger Ellison syndrome?

Answer 1

Gastrinoma

Question 2

What is gastrinoma ?

Answer 2

Multiple ulcers resistant to ttt

Question 3

Diagnosis of ZES?

Answer 3

1. Gastrin level (stimulated with intravenous Ca)

2. Localization of tumor CT scan

Question 4

What is you cannot localize any tumor?

Answer 4

1. Blind body and tail pancreatectomy ( tumor usually present in the body or tail)
2. Total gastrectomy to remove the target organ
3. Omeprazole in large doses for 6 to 12 months

Question 5

Gastrinoma triangle?

Answer 5

1. Cystic duct and CBD
2. Junction between 3rd and 4th part of duodenum
3. Junction between head and neck of pancreas

Question 6

What is gastrin hormone?

Answer 6

Peptide hormone that stimulate secretion of gastric acid HCL by the parietal cells of the stomach and aids in gastric mobility

Question 7

Normal level of gastrin level?

Answer 7

<150 ng/L

Question 8

Gastric level with stimulation of intravenous Ca in ZES?

Answer 8

Most patients show >500ng/L

Gastrin level increase by 200pg/ml > the basal level following secretin injection

Question 9

ZES pt has diarrhea because?

Answer 9

1. The hyperacidity inhibits the pancreatic enzymes (malabsoption diarrhea) MAINLY
2. Gastrin increases intestinal motility