gastroenterology cases
Gastric Ulcer with Gastrocolic fistula due to...
Computerized Tomography Scan. Six year after the total gastrectomy the patient has been stable with no symptoms, the cat scan displays a large mass in the head of the pancreas with no metastases...
Gastric Ulcer with Gastrocolic fistula due to...
Gastrinomas are an integral part of the Zollinger-Ellison syndrome (ZES) In fact, ZES is also known as gastrinoma. This syndrome consists of ulcer disease in the upper gastrointestinal tract, marked...
Gastric Ulcer with Gastrocolic fistula due to...
Surgically, gastrinomas are often difficult to locate, even with careful inspection. They may be missed in at least 10–20% of patients with ZES. Gastrinomas are sometimes found only because they have...
Gastric Ulcer with Gastrocolic fistula due to...
Diagnostic imaging techniques help locate the gastrinomas. The most sophisticated is radionuclide octreotide scanning (also known as somatostatin receptor scintigraphy or 111In pentetreotide SPECT.
Gastric Ulcer with Gastrocolic fistula due to...
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...
Gastric Ulcer with Gastrocolic fistula due to...
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,...
Gastric Ulcer with Gastrocolic fistula due to...
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...
Gastric Ulcer with Gastrocolic fistula due to...
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...
Gastric Ulcer with Gastrocolic fistula due to...
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...
Gastric Ulcer with Gastrocolic fistula due to...
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...
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Gottumukkala Raju
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