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    Occupational contact allergy to omeprazole and ranitidine.
    Med Pr 2017 May 20;68(3):433-435. Epub 2017 Mar 20.
    University of Barcelona, Barcelona, Spain (Unit of Occupational Medicine, School of Medicine).
    Omeprazole is a proton pump inhibition and ranitidine is an H2 histamine receptor antagonist widely used in the treatment of gastroesophageal reflex disease, peptic ulcer disease, Zollinger-Ellison syndrome and as a protector of the gastric mucosae. We report a case of occupational contact allergy to omeprazole and ranitidine. A 48-year-old man, with no pre-existing history of atopy or lifestyle factors. Read More

    Neuroendocrine Tumors of the Stomach.
    Surg Clin North Am 2017 Apr 3;97(2):333-343. Epub 2017 Mar 3.
    Department of Surgery, UAB Hospital and Health System, UAB Comprehensive Cancer Center, University of Alabama at Birmingham, BDB 502, 1808 7th Avenue South, Birmingham, AL 35233, USA.
    Gastric neuroendocrine tumors (NETs) are classified into three types. Type I gastric NETs are associated with chronic atrophic gastritis. They have a good prognosis and endoscopic resection is the mainstay of treatment. Read More

    A Perplexing Case of Abdominal Pain That Led to the Diagnosis of Zollinger-Ellison Syndrome.
    Case Rep Gastrointest Med 2017 21;2017:7636952. Epub 2017 Feb 21.
    Division of Gastroenterology and Hepatology, Henry Ford Hospital, Detroit, MI 48202, USA.
    Zollinger-Ellison syndrome (ZES) is a rare clinical disorder, characterized by hypersecretion of gastric acid and multiple ulcers distal to the duodenal bulb. This occurs via the release of gastrin by neuroendocrine tumors known as gastrinomas. Patients with ZES present with nonspecific GI symptoms, which often leads to a delay in diagnosis. Read More

    Deprescribing versus continuation of chronic proton pump inhibitor use in adults.
    Cochrane Database Syst Rev 2017 Mar 16;3:CD011969. Epub 2017 Mar 16.
    Bruyère Research Institute, University of Ottawa, 43 rue Bruyere St, Room 730D, Ottawa, ON, Canada, K1N 5C8.
    Background: Proton pump inhibitors (PPIs) are a class of medications that reduce acid secretion and are used for treating many conditions such as gastroesophageal reflux disease (GERD), dyspepsia, reflux esophagitis, peptic ulcer disease, and hypersecretory conditions (e.g. Zollinger-Ellison syndrome), and as part of the eradication therapy for Helicobacter pylori bacteria. Read More

    A case of type 1 multiple endocrine neoplasia with esophageal stricture successfully treated with endoscopic balloon dilation and local steroid injection combined with surgical resection of gastrinomas.
    BMC Gastroenterol 2017 Mar 7;17(1):37. Epub 2017 Mar 7.
    Division of Endoscopy, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi, Suntogun, Shizuoka, 411-8777, Japan.
    Background: In type 1 multiple endocrine neoplasia (MEN1), esophageal diseases association with excessive gastrin secretion in Zollinger-Ellison syndrome (ZES) sometimes develop. Here, we reported a case of MEN1/ZES, who developed dysphagia due to reflux esophagitis with severe esophageal stricture. Treatment for his esophageal stricture and ZES was discussed. Read More

    Zollinger-Ellison Syndrome: A Rare Case of Chronic Diarrhea.
    Gastroenterology Res 2016 Dec 23;9(6):103-104. Epub 2016 Dec 23.
    Internal Medicine Residency Program, Prince George's Hospital, Cheverly, MD, USA.
    Zollinger-Ellison syndrome (ZES) is caused by hypersecretion of gastrin from duodenal or pancreatic gastrinomas. We report a case of a 57-year-old female who presented with chronic diarrhea. CT abdomen showed multiple liver masses. Read More

    Zollinger-Ellison syndrome: an unusual case of chronic diarrhoea in a child.
    Malays J Pathol 2016 Dec;38(3):321-325
    Postgraduate Institute of Medical Education and Research, Divisions of Pediatric GE, Chandigarh (UT) -160 012 INDIA.
    Most cases of Zollinger-Ellison syndrome (ZES) are described in adults. It is a rare disorder in childhood. Most cases present with abdominal pain due to peptic ulceration and chronic diarrhoea not responding to general measures. Read More

    Assessing for Multiple Endocrine Neoplasia Type 1 in Patients Evaluated for Zollinger-Ellison Syndrome-Clues to a Safer Diagnostic Process.
    Am J Med 2017 May 21;130(5):603-605. Epub 2016 Dec 21.
    Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Mayo Clinic, Rochester, Minn. Electronic address:
    Background: Zollinger-Ellison syndrome is a rare cause of tumoral hypergastrinemia; 1 of 5 patients with this syndrome also has multiple endocrine neoplasia type 1. The diagnosis of this disease is complicated by the widespread use of proton pump inhibitors that can elevate serum gastrin levels, the cornerstone for biochemical diagnosis. Abrupt discontinuation of proton pump inhibitors could lead to adverse outcomes. Read More

    [Subtype classification and clinicopathological characteristics of gastric neuroendocrine neoplasms: an analysis of 241 cases].
    Zhonghua Wei Chang Wai Ke Za Zhi 2016 Nov;19(11):1241-1246
    Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing 100029, China.
    Objective: To study subtype classification of gastric neuroendocrine neoplasm (NEN) and their clinicopathological characteristics in order to provide reference for clinical practice.

    Methods: Clinicopathological data of 241 gastric NEN patients (174 cases from China-Japan Friendship Hospital and 67 cases from The First Affiliated Hospital of Sun Yat-Sen University) between January 2011 and June 2016 were retrospectively summarized. According to serum gastrin, 24-hour intragastric pH monitoring and pathological grade, patients with gastric NEN were divided into 4 types: type I( (hypergastrinemia and achlorhydria, related to autoimmune chronic atrophic gastritis), type II( [hypergastrinemia and Zollinger-Ellison syndrome, related to gastrinoma or multiple endocrine neoplasia type I( (MEN-I()], type III( (sporadic disease with normal serum gastrin level), and type IIII( [poorly differentiated gastric neuroendocrine carcinoma (NEC) and mixed adenoneuroendocrine carcinoma (MANEC)]. Read More

    [Basic and translational research progress of gastrointestinal neuroendocrine neoplasmas].
    Zhonghua Wei Chang Wai Ke Za Zhi 2016 Nov;19(11):1217-1221
    Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
    Gastrointestinal neuroendocrine tumors are a group of highly heterogeneous tumors. Their incidences have increased in the Western countries as well as in Asia for years. In recent years, predominant progression has been made in the basic and translational studies on gastrointestinal neuroendocrine tumors. Read More

    Operation for insulinomas in multiple endocrine neoplasia type 1: When pancreatoduodenectomy is appropriate.
    Surgery 2017 Mar 15;161(3):727-734. Epub 2016 Nov 15.
    Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
    Background: Distal pancreatectomy is the most frequent operation for insulinomas complicating multiple endocrine neoplasia type 1 insulinoma, although there are conditions for which a different operative approach might be preferable. In this article, we report the operative experience of a referral center for multiple endocrine neoplasia type 1 insulinoma.

    Methods: Twelve patients underwent operations between 1992 and 2015: 8 underwent a distal pancreatic resection, and 4 underwent a pancreatoduodenectomy. Read More

    Inhibiting the proton pump: mechanisms, benefits, harms, and questions.
    BMC Med 2016 Nov 9;14(1):172. Epub 2016 Nov 9.
    Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK.
    Inhibition of the H(+)/K(+)-adenosine triphosphatase (the proton pump) is the final common mechanistic pathway in reducing gastric acid secretion pharmacologically. Proton pump inhibitors are widely used in upper gastrointestinal diseases, including gastric and duodenal ulcers, eradication of Helicobacter pylori in combination with antibiotics, gastroesophageal reflux disease, Zollinger-Ellison syndrome, eosinophilic esophagitis, and prevention of non-steroidal anti-inflammatory drug-induced peptic ulceration. Reviewing their benefits and harms in BMC Medicine, Scarpignato et al. Read More

    Effective and safe proton pump inhibitor therapy in acid-related diseases - A position paper addressing benefits and potential harms of acid suppression.
    BMC Med 2016 Nov 9;14(1):179. Epub 2016 Nov 9.
    Division of Pharmacology, Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy.
    Background: The introduction of proton pump inhibitors (PPIs) into clinical practice has revolutionized the management of acid-related diseases. Studies in primary care and emergency settings suggest that PPIs are frequently prescribed for inappropriate indications or for indications where their use offers little benefit. Inappropriate PPI use is a matter of great concern, especially in the elderly, who are often affected by multiple comorbidities and are taking multiple medications, and are thus at an increased risk of long-term PPI-related adverse outcomes as well as drug-to-drug interactions. Read More

    Treatment of symptomatic neuroendocrine tumor syndromes: recent advances and controversies.
    Expert Opin Pharmacother 2016 Nov 23;17(16):2191-2205. Epub 2016 Sep 23.
    b Digestive Diseases Branch , NIDDK, NIH , Bethesda , MD , USA.
    Introduction: Neuroendocrine tumors(NETs), once thought rare, are increasing in frequency in most countries and receiving increasing-attention. NETs present two-treatment problems. A proportion is aggressive and a proportion has a functional, hormone-excess-state(F-NET), each of which must be treated. Read More

    Management of gastric and duodenal neuroendocrine tumors.
    World J Gastroenterol 2016 Aug;22(30):6817-28
    Yuichi Sato, Satoru Hashimoto, Ken-ichi Mizuno, Manabu Takeuchi, Shuji Terai, Department of Gastroenterology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8121, Japan.
    Gastrointestinal neuroendocrine tumors (GI-NETs) are rare neoplasms, like all NETs. However, the incidence of GI-NETS has been increasing in recent years. Gastric NETs (G-NETs) and duodenal NETs (D-NETs) are the common types of upper GI-NETs based on tumor location. Read More

    Drug-Induced Vitamin B12 Deficiency: A Focus on Proton Pump Inhibitors and Histamine-2 Antagonists.
    J Pharm Pract 2016 Aug 12. Epub 2016 Aug 12.
    Presbyterian College School of Pharmacy, Clinton, SC, USA
    Objective: To review primary literature of gastric acid suppressive agents and vitamin B12 deficiency.

    Data Synthesis: From the published articles, proton pump inhibitors (PPIs) are associated with a higher risk of inducing vitamin B12 deficiency than histamine-2 receptor antagonists (H2RAs). Literature suggests that there is an increased risk of developing vitamin B12 deficiency in patients who are exposed to extended durations of therapy with PPIs. Read More

    Primary Pancreatic Secretinoma: Further Evidence Supporting Secretin as a Diarrheogenic Hormone.
    Ann Surg 2016 Aug 5. Epub 2016 Aug 5.
    *Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH †Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH ‡Department of Surgery, Center for Regenerative Medicine and Cell Based Therapies, Comprehensive Wound Center, Laser Capture Molecular Core, The Ohio State University Wexner Medical Center, Columbus, OH §Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, WI ¶Department of Surgery, University of California at Los Angeles, School of Medicine, Los Angeles, CA ||Department of Surgery, Florida State University, Tallahassee, FL **William and Sheila Konar Center for Digestive and Liver Diseases, Division of Gastroenterology and Hepatology, University of Rochester Medical Center, Rochester, NY.
    Objectives: To document the existence of primary pancreatic secretinoma in patients with watery diarrhea syndrome (WDS) and achlorhydria and establish secretin as a diarrheogenic hormone.

    Background: Vasoactive intestinal peptide (VIP) has been widely accepted as the main mediator of WDS. However, in 1968, Zollinger et al reported 2 female patients with pancreatic neuroendocrine tumors, WDS, and achlorhydria. Read More

    Sporadic Gastric Well-Differentiated Neuroendocrine Tumors Have a Higher Ki-67 Proliferative Index.
    Endocr Pathol 2016 Sep;27(3):259-67
    Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
    Well-differentiated neuroendocrine tumor (WDNET) of the stomach can arise in three distinct clinical settings: (1) in association with autoimmune atrophic gastritis, (2) in association with multiple neuroendocrine neoplasia type I (MEN I) or Zollinger-Ellison syndrome (ZES), or (3) sporadic. The Ki-67 proliferative index (PI) in gastric WDNETs in these three distinct clinical settings has not been evaluated in detail. Forty-five gastric WNETs underwent polypectomy (n = 4), endoscopic mucosal resection (n = 12), and surgical resection (n = 29) between 1994 and 2015 were included. Read More

    Zollinger-Ellison Syndrome Associated with von Recklinghausen Disease: Case Report and Literature Review.
    Am J Case Rep 2016 Jun 13;17:398-405. Epub 2016 Jun 13.
    Department of Gastroenterology, Aleppo University, Aleppo, Syrian Arab Republic.
    Background: Pancreatic endocrine tumors (PETs) are rare and can occur as part of neurofibromatosis type 1 (NF1). Gastrinomas are functional PETs that are rarely associated with NF1. Only two cases of their occurrence have been reported in the literature. Read More

    [Management of gastrinoma].
    Presse Med 2016 Nov 1;45(11):986-991. Epub 2016 Jun 1.
    AP-HP, hôpital Cochin, service de chirurgie digestive hépato-biliaire et endocrienne, Paris, France; Université Paris Descartes, 12, rue de l'École-de-Médecine, 75006 Paris, France. Electronic address:
    Gastrinoma is a very rare tumor leading to gastrin hypersecretion and characterised by Zollinger-Ellisson syndrome (ZES) i.e. severe gastric and duodenal ulceration and profuse diarrhea. Read More

    Synchronous Peripancreatic Lymph Node Gastrinoma and Gastric Neuroendocrine Tumor Type 2.
    Clin Endosc 2016 Sep 20;49(5):483-487. Epub 2016 May 20.
    Department of Hematology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
    A 34-year-old man was referred to our hospital with gastric polypoid lesions and biopsy-confirmed neuroendocrine tumor (NET). Computed tomography (CT) revealed a 3×3.5×8-cm retroperitoneal mass behind the pancreas, with multiple hepatic metastases. Read More

    Clinical treatment of gastrinoma: A case report and review of the literature.
    Oncol Lett 2016 May 31;11(5):3433-3437. Epub 2016 Mar 31.
    Department of Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310009, P.R. China.
    Gastrinoma is a gastrin-secreting tumor that is associated with Zollinger-Ellison syndrome. The majority of cases occur in the pancreas, followed by the duodenum. Early diagnosis is difficult due to the relative rarity of the tumor and the lack of specific symptoms. Read More

    Stereoselective Pharmacodynamics and Pharmacokinetics of Proton Pump Inhibitors.
    Curr Drug Metab 2016 Mar 22. Epub 2016 Mar 22.
    Research Division of Clinical Pharmacology, The first affiliated hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, China, 210029.
    Proton pump inhibitors (PPIs) are a group of gastric acid suppressing drugs, that are strong and long-lasting inhibitors of the proton pump (referred to as acid pump antagonists). They work by irreversibly blocking the H+/K+ ATPase. PPIs are used to treat peptic ulcer disease, gastroesophageal reflux disease, nonsteroidal anti-inflammatory drug-induced gastrointestinal lesions, and Zollinger-Ellison syndrome. Read More

    A short history of neuroendocrine tumours and their peptide hormones.
    Best Pract Res Clin Endocrinol Metab 2016 Jan 23;30(1):3-17. Epub 2015 Oct 23.
    Yale University School of Medicine, New Haven, CT, USA.
    The discovery of neuroendocrine tumours of the gastrointestinal tract and pancreas started in 1870, when Rudolf Heidenhain discovered the neuroendocrine cells, which can lead to the development of these tumours. Siegfried Oberndorfer was the first to introduce the term carcinoid in 1907. The pancreatic islet cells were first described in 1869 by Paul Langerhans. Read More

    [Endoscopic therapy for gastroduodenal neuroendocrine neoplasms].
    Chirurg 2016 Apr;87(4):271-9
    Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie (einschließlich Arbeitsbereich Stoffwechselerkrankungen), Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Deutschland.
    Neuroendocrine neoplasms (NEN) represent a group of potentially malignant tumors, which can be located in every section of the gastrointestinal tract, the pancreas and the bronchopulmonary system. Gastroduodenal NENs have a relatively good prognosis in comparison to other subentities, e.g. Read More

    Imaging in multiple endocrine neoplasia type 1: recent studies show enhanced sensitivities but increased controversies.
    Int J Endocr Oncol 2016;3(1):53-66. Epub 2016 Jan 18.
    Digestive Diseases Branch, NIDDK, NIH, Bethesda, MD 20817, USA.
    In multiple endocrine neoplasia type 1 (MEN1) patients, a number of recent studies compare the ability of different, new imaging modalities to existing modalities to localize the important neuroendocrine tumors (NETs) that contribute to their decreased life expectancy (pancreatic NETs [pNETs] and thymic carcinoids). These included the use of (68)Ga-DOTATOC-PET/CT, endoscopic ultrasound and MRI. The current paper analyzes these results in light of current guidelines and controversies involved in the treatment/management of MEN1 patients. Read More

    Syndromic versus non-syndromic sporadic gastrin-producing neuroendocrine tumors of the duodenum: comparison of pathological features and biological behavior.
    Virchows Arch 2016 Mar 9;468(3):277-87. Epub 2015 Dec 9.
    Department of Pathology, Consultation Center for Pancreatic and Endocrine Tumors, Technical University, Munich, Germany.
    Sporadic gastrin-producing neuroendocrine tumors of the duodenum present either with the Zollinger-Ellison syndrome (ZES) or with unspecific symptoms. While syndromic gastrin-producing neuroendocrine tumors often show metastases at the time of diagnosis, those without a syndrome do not. The aim of the study was to search for clinicopathological features that may distinguish the two categories of gastrin-producing duodenal tumors. Read More

    Gastric Hypersecretory States: Investigation and Management.
    Curr Treat Options Gastroenterol 2015 Dec;13(4):386-97
    Department of Medicine, David Geffen School of Medicine, Los Angeles, CA, USA.
    Opinion Statement: Hypersecretory conditions affecting the stomach account for significant morbidity and mortality manifested in some cases with peptic ulcer, gastrointestinal hemorrhage, and/or gastroesophageal reflux disease (GERD). The diagnosis of gastric acid hypersecretory states can be challenging and relies on the use of quantitative assays to measure gastric acid secretion and serum gastrin. The most common etiology for hypergastrinemia is the use of potent gastric acid inhibitors such as the proton pump inhibitors. Read More

    Biochemical Testing in Patients with Neuroendocrine Tumors.
    Front Horm Res 2015 14;44:24-39. Epub 2015 Aug 14.
    Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Neuroendocrine tumors are usually slow-growing tumors. Many of these are capable of secreting peptide hormones or biogenic amines that may lead to endocrine syndromes. Nonfunctioning tumors can either secrete no hormones at all, or secrete hormones not giving rise to endocrine symptoms, such as chromogranin A, chromogranin B or pancreatic polypeptide. Read More

    Diagnostic and Treatment Approaches for Refractory Peptic Ulcers.
    Clin Endosc 2015 Jul 24;48(4):285-90. Epub 2015 Jul 24.
    Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
    Refractory peptic ulcers are defined as ulcers that do not heal completely after 8 to 12 weeks of standard anti-secretory drug treatment. The most common causes of refractory ulcers are persistent Helicobacter pylori infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs). Simultaneous use of two or more H. Read More

    Intraoperative Use of a Portable Large Field of View Gamma Camera and Handheld Gamma Detection Probe for Radioguided Localization and Prediction of Complete Surgical Resection of Gastrinoma: Proof of Concept.
    J Am Coll Surg 2015 Aug 1;221(2):300-8. Epub 2015 Apr 1.
    Department of Surgery, College of Public Health, The Ohio State University, Wexner Medical Center, Columbus, OH.
    Background: Surgical management of Zollinger-Ellison syndrome (ZES) relies on localization and resection of all tumor foci. We describe the benefit of combined intraoperative use of a portable large field of view gamma camera (LFOVGC) and a handheld gamma detection probe (HGDP) for indium-111 ((111)In)-pentetreotide radioguided localization and confirmation of gastrinoma resection in ZES.

    Study Design: Five patients (6 cases) with (111)In-pentetreotide-avid ZES were evaluated. Read More

    Weight Gain in Zollinger-Ellison Syndrome After Acid Suppression.
    Pancreas 2016 Feb;45(2):193-7
    From the *Division of Gastroenterology and †Department of Surgery, Hospital of the University of Pennsylvania, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
    Objectives: Zollinger-Ellison syndrome (ZES) is characterized by hypergastrinemia and gastric acid hypersecretion resulting in peptic ulcer disease, diarrhea, and weight loss. Acid secretion can be controlled with medication, and biochemical cure is possible with surgery. Data on how these interventions affect patients' weight are lacking. Read More

    Somatostatin analogs for gastric carcinoids: For many, but not all.
    World J Gastroenterol 2015 Jun;21(22):6785-93
    Sara Massironi, Alessandra Zilli, Dario Conte, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, I-20122 Milan, Italy.
    Gastric carcinoids (GCs) are classified as: type I, related to hypergastrinemia due to chronic atrophic gastritis (CAG), type II, associated with Zollinger-Ellison syndrome in multiple endocrine neoplasia type 1, and type III, which is normogastrinemic. The management of type-I gastric carcinoids (GC1s) is still debated, because of their relatively benign course. According to the European Neuroendocrine Tumor Society guidelines endoscopic resection is indicated whenever possible; however, it is not often feasible because of the presence of a multifocal disease, large lesions, submucosal invasion or, rarely, lymph node involvement. Read More

    Gastric neuroendocrine neoplasms and proton pump inhibitors: fact or coincidence?
    Scand J Gastroenterol 2015 10;50(11):1397-403. Epub 2015 Jun 10.
    Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Gastroenterology and Endoscopic Unit , Milan , Italy.
    Objective: Reporting on three cases of gastric neuroendocrine tumors (g-NETs) in patients taking long-term proton pump inhibitors (PPIs). These tumors are not classifiable considering current criteria. g-NETs are currently grouped as: types 1 and 2, related to hypergastrinemia due to chronic atrophic gastritis and Zollinger-Ellison syndrome respectively, and type 3, normogastrinemic and more aggressive. Read More

    Treatment of Severe Metabolic Alkalosis with Continuous Renal Replacement Therapy: Bicarbonate Kinetic Equations of Clinical Value.
    ASAIO J 2015 Jul-Aug;61(4):e20-5
    From the *Division of Nephrology and Hypertension, †Division of Pulmonary and Critical Care Medicine, and ‡Department of General Surgery, Henry Ford Hospital, Detroit, Michigan.
    Concomitant severe metabolic alkalosis, hypernatremia, and kidney failure pose a therapeutic challenge. Hemodialysis to correct azotemia and abnormal electrolytes results in rapid correction of serum sodium, bicarbonate, and urea but presents a risk for dialysis disequilibrium and brain edema. We describe a patient with Zollinger-Ellison syndrome with persistent encephalopathy, severe metabolic alkalosis (highest bicarbonate 81 mEq/L), hypernatremia (sodium 157 mEq/L), and kidney failure despite 30 hours of intravenous crystalloids and proton pump inhibitor. Read More

    Determinants of surgical resection for pancreatic neuroendocrine tumors.
    J Hepatobiliary Pancreat Sci 2015 Aug 13;22(8):610-7. Epub 2015 Mar 13.
    Department of Surgery, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu, Shiga, 520-8511, Japan.
    Pancreatic neuroendocrine tumors (pNETs) include functioning and non-functional tumors. Functioning tumors consist of tumors that produce a variety of hormones and their clinical effects. Therefore, determinants of resection of pNETs should be discussed for each group of tumors. Read More

    [Surgery for gastrinoma: Short and long-term results].
    Cir Esp 2015 Jun-Jul;93(6):390-5. Epub 2015 Mar 3.
    Departamento de Cirugía, Universidad de Barcelona, Hospital Clínic de Barcelona, Barcelona, España.
    Introduction: Zollinger-Ellison syndrome (Z-E) is characterized by gastrin-secreting tumors, responsible for causing refractory and recurrent peptic ulcers in the gastrointestinal tract. The optimal approach and the extension of tumor resection remains the subject of debate.

    Methods: During the period February 2005 and February 2014, 6 patients with Z-E underwent surgery, 4 men and 2 women with a median age 46. Read More

    Gastroenterol Rep (Oxf) 2015 Aug 18;3(3):201-8. Epub 2015 Feb 18.
    Internal Medicine, Emory University, Atlanta, GA, USA.
    Gastrin is an important hormone of the digestive system, which assists gastric acid secretion. It may be pathologically elevated in conditions such as Zollinger-Ellison syndrome, or due to common medications such as proton pump inhibitors. In this review we provide an overview of the pathophysiology and medical causes of hypergastrinemia, diagnostic testing and clinical consequences of chronic hypergastrinemia. Read More

    Clinical features of pancreatic neuroendocrine tumors.
    J Hepatobiliary Pancreat Sci 2015 Aug 17;22(8):578-85. Epub 2015 Feb 17.
    Neuroendocrine Tumor Unit, Endocrinology and Metabolism Service, Department of Medicine, Hadassah-Hebrew University Medical Center, P.O.B. 12000, Jerusalem, 91120, Israel.
    Pancreatic neuroendocrine tumors (PNETs), also known as islet cell tumors, are rare neoplasms that arise in the endocrine tissues of the pancreas. Most of pancreatic NETs (50-75%) are nonfunctioning (not associated with a hormonal clinical syndrome); however, in up to one third they can secrete a variety of peptide hormones, including insulin, gastrin, glucagon, vasoactive intestinal peptide, somatostatin etc., resulting in rare but unique clinical syndromes. Read More

    Zollinger-Ellison syndrome: Revelation of the gastrinoma triangle.
    Radiol Case Rep 2015 3;10(1):827. Epub 2015 Dec 3.
    Zollinger-Ellison syndrome is a complex condition in which one or more tumors form in the patient's pancreas or upper duodenum. These tumors, called gastrinomas, secrete excessive amounts of gastrin, and almost all develop ulcers. The vast majority of gastrinomas are present within the "gastrinoma triangle," which is composed of the porta hepatis, duodenal sweep, and pancreatic head. Read More

    Long-term proton pump inhibitor (PPI) use and the development of gastric pre-malignant lesions.
    Cochrane Database Syst Rev 2014 Dec 2(12):CD010623. Epub 2014 Dec 2.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, Stockholm, SE- 17177, Sweden.
    Background: Proton pump inhibitors (PPIs) are the most effective drugs to reduce gastric acid secretion. PPIs are one of the most commonly prescribed classes of medications worldwide. Apart from short-term application, maintenance therapy with PPIs is recommended and increasingly used in certain diseases, such as Zollinger-Ellison syndrome and gastro-oesophageal reflux disease, especially for people with erosive oesophagitis or Barrett's oesophagus. Read More

    Primary lymph node gastrinoma. A diagnosis of exclusion. A case for duodenotomy in the setting of a negative imaging for primary tumor: A case report and review of the literature.
    Int J Surg Case Rep 2014 17;5(11):849-52. Epub 2014 Oct 17.
    Department of Surgery, Mount Sinai-St. Luke's-Roosevelt Hospital Center, New York, NY, United States.
    Introduction: Zollinger-Ellison syndrome (ZES) is caused by uninhibited secretion of gastrin from a gastrinoma. Gastrinomas most commonly arise within the wall of the duodenum followed by the pancreas. Primary lymph node gastrinomas have also been reported in the literature. Read More

    From hypomagnesaemia to Zollinger-Ellison syndrome: an adverse effect of a proton pump inhibitor.
    BMJ Case Rep 2014 Oct 1;2014. Epub 2014 Oct 1.
    The B. Shine Rheumatology Unit and Internal Medicine H, Rambam Health Care Campus and the Rappaport's Faculty of Medicine, Technion, Haifa, Israel.
    We describe the case of a 53-year-old man who presented with abdominal pain, diarrhoea and hypomagnesaemia. The hypomagnesaemia proved to be due to gastrointestinal loss as urinary fractional excretion was very low, suggesting non-renal loss. Common causes were discarded and the hypomagnesaemia was attributed to chronic use of the proton pump inhibitor, omeprazole. Read More

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