fistula

The radiological detection of endocrine tumors of the pancreas poses a difficult challenge to the radiologist because of the small size of most of these tumors and frequently requires the combined use of different imaging modalities....

Over 90% of gastrinomas are found within an anatomic triangle referred to as the gastrinoma triangle. The 3 points that define this region are: (1) the confluence of the cystic and common bile duct, (2) the junction of the second...

Clinical Features of ZES The mean age at presentation is 45-50 years, and men are affected more often than women. Because of the rarity of the disease, the average interval between onset of symptoms and diagnosis is about 6 years....

Clinical Features of ZES Peptic ulcer disease: This disease is present in 90%-95% of patients with gastrinomas. Patients who are Helicobacter pylori infection-negative and have no history of nonsteroidal anti -inflammatory drug...

Clinical Features of ZES Diarrhea: This symptom may precede ulcer symptoms and is seen in over 30% of patients with gastrinoma Diarrhea results not only from gastric acid hypersecretion and subsequent activation of pepsinogens by...

Clinical Features of ZES Less frequently, ZES may present as: Vitamin B12 malabsorption: This deficiency may develop because low intraluminal intestinal pH interferes with intrinsic factor-facilitated active absorption of vitamin...

More images of the Computerized Tomography Scan.