[A woman with shock as first sign of Zollinger-Ellison syndrome]

Ned Tijdschr Geneeskd. 2007 Feb 24;151(8):478-83.
[Article in Dutch]

Abstract

A 49-year-old woman presented at the emergency ward in shock with upper gastrointestinal bleeding. Extensive ulceration confirmed by gastroduodenoscopy was suggestive of Zollinger-Ellison syndrome. Further evaluation by fasting gastrin assessment, CT, endosonography with cytological biopsy and somatostatin-receptor scintigraphy confirmed the diagnosis ofgastrinoma. Three enlarged lymph nodes near the pancreatic head were surgically removed; each was found to contain neuroendocrine tumour cells. The patient recovered rapidly after surgery and the gastrin level normalised. Zollinger-Ellison syndrome is uncommon but should be considered as a possible cause of upper gastrointestinal bleeding. Shock is very rarely the first sign ofZollinger-Ellison syndrome. In this case, the use of a proton-pump inhibitor may have masked the disease for years.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Diagnosis, Differential
  • Female
  • Gastrinoma / diagnosis*
  • Gastrinoma / surgery
  • Gastrointestinal Hemorrhage / etiology
  • Humans
  • Middle Aged
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / surgery
  • Shock, Hemorrhagic / etiology*
  • Treatment Outcome
  • Zollinger-Ellison Syndrome / diagnosis*
  • Zollinger-Ellison Syndrome / surgery