Zollinger-Ellison Syndrome: An Uncommon Cause of Peptic Ulcer Disease and Chronic Diarrhea

Authors

  • Thagoon Kanjanopas Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand
  • Arunchai Chang Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand
  • Keerati Akarapatima Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand
  • Cheep Charoenlap Department of Anatomical Pathology, Hatyai Hospital, Songkhla, Thailand
  • Songklod Pakdeejit Division of Intervention Radiology, Department of Radiology, Hatyai Hospital, Songkhla, Thailand
  • Attapon Rattanasupa Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand

Keywords:

Zollinger-Ellison syndrome, Gastrinoma, Chronic diarrhea, Peptic ulcer disease, Multiple Endocrine Neoplasia-type 1

Abstract

Background and Objective: Zollinger-Ellison syndrome (ZES) is an extremely rare condition caused by a neuroendocrine tumor, namely gastrinoma, associated with gastric acid overproduction. The typical presentations include recurrent peptic ulcers accompanied by chronic diarrhea.

Method: We present a case report using the information extracted from medical records at Hatyai Hospital.

Results: A 55-year-old woman presented with intermittent epigastric pain and chronic diarrhea. Upper endoscopy revealed multiple small gastric polyps accompanied by multiple ulcers in the postbulbar region. Magnetic resonance imaging showed a hypervascular tumor located in the gastrinoma triangle with liver metastasis. The condition was diagnosed as an aggressive gastrinoma based on the histopathology. The patient’s symptoms responded well to supportive treatment.

Conclusion: The present case emphasizes the importance of having high clinical suspicion of ZES, especially in patients presenting with peptic ulcer disease and chronic diarrhea, which may help in the early diagnosis of the patient and provide appropriate treatment.

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Published

2022-06-24

How to Cite

1.
Kanjanopas T, Chang A, Akarapatima K, Charoenlap C, Pakdeejit S, Rattanasupa A. Zollinger-Ellison Syndrome: An Uncommon Cause of Peptic Ulcer Disease and Chronic Diarrhea. SRIMEDJ [Internet]. 2022 Jun. 24 [cited 2024 Apr. 24];37(3):287-92. Available from: https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/253140

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Case report