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The Management of Zollinger-Ellison Syndrome

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The Stomach

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Abstract

The most difficult step in making the diagnosis of Zollinger-Ellison syndrome (ZES) is to think of the possibility. The typical presentation is no longer that of severe peptic ulceration in unusual sites, as originally described (Ellison and Wilson 1964). Patients often have a typical peptic ulcer, or they may have persistent, recurrent, or complicated peptic ulcer disease, severe esophagitis, or watery diarrhea or malabsorption with or without peptic ulcer disease (Jensen et al. 1986, Wolfe and Jensen 1987). Some patients may have renal stones and a family history of ulcers or other complaints (Eberle and Grun 1981). The diagnosis of ZES should also be entertained in any patient undergoing gastric surgery. The best screening test for ZES is measurement of the fasting serum gastrin (normal < 100 pg/ml). For the initial screen the patient can continue to take antisecretory medication, but if the gastrin result in the range 110–500 pg/ml with H2-antagonists or 110–3000 pg/ml with omeprazole, the test should be repeated after the patient has stopped taking H2-antagonists for 24 h or omeprazole for 6 days (Wolfe and Jensen 1987).

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  1. P. N. Maton
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Editors and Affiliations

  1. University of Münster, Albert-Schweitzer-Str. 33, D-48149, Münster, Germany

    W. Domschke MD MD(hon) FACG (Chairman of the Department of Medicine B) (Chairman of the Department of Medicine B)

  2. University of Kraków, ul. Grzegórzecka 16, PL-31531, Kraków, Poland

    S. J. Konturek MD (Chairman of the Institute of Physiology) (Chairman of the Institute of Physiology)

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© 1993 Springer-Verlag Berlin Heidelberg

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Maton, P.N. (1993). The Management of Zollinger-Ellison Syndrome. In: Domschke, W., Konturek, S.J. (eds) The Stomach. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78176-6_18

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  • DOI: https://doi.org/10.1007/978-3-642-78176-6_18

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-56613-7

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