3,557 results match your criteria Zollinger-Ellison Syndrome


Management of Primary Lymph Nodal Gastrinoma With Liver Metastases Resulting in Zollinger-Ellison Syndrome.

Clin Nucl Med 2019 Jan;44(1):e36-e39

From the Departments of Nuclear Medicine.

Primary lymph node gastrinoma has been defined as gastrin-producing tumor present in lymph nodes and predominantly found in well-defined anatomical region known as gastrinoma triangle. They are usually localized preoperatively with imaging, and their surgical resection results in long-term relief. The authors report a case of unresectable primary lymph nodal gastrinoma with liver metastases in a 14-year-old adolescent boy with proven histopathology detected on Ga-DOTANOC whole-body PET/CT scan followed by preoperative multiple Lu-DOTATATE cycles for cytoreduction. Read More

View Article
January 2019
19 Reads

Gastrinoma of Cystic Duct: A Rare Association With Multiple Endocrine Neoplasia Type 1.

J Clin Med Res 2018 Nov 9;10(11):843-847. Epub 2018 Oct 9.

Department of Internal Medicine and Endocrine Unit, Medical School and Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

Neuroendocrine tumors (NETs) of cystic duct are extremely rare, accounting for less than 2% of NET cases. The association of biliary tree NET and multiple endocrine neoplasm type 1 (MEN1) are even more rare. In this report, we described a case of a 65-year-old woman who was referred to our neuroendocrine outpatient clinic to investigate MEN1 after an incidental diagnosis of gastrinoma. Read More

View Article
November 2018
5 Reads

Proton pump inhibitors: use and misuse in the clinical setting.

Expert Rev Clin Pharmacol 2018 Nov 10;11(11):1123-1134. Epub 2018 Oct 10.

b Gastrointestinal Unit, Department of Surgery , Oncology and Gastroenterology, University of Padua , Padua , Italy.

Introduction: The introduction of proton pump inhibitors (PPIs) into clinical practice has greatly improved our therapeutic approach to acid-related diseases for their efficacy and safety. Areas Covered: The following evidence-based indications for PPI use are acknowledged by many scientific societies: treatment of the various forms and complications of gastroesophageal reflux disease, eradication of H. pylori infection in combination with two or more antibiotics, short- and long-term therapy of H. Read More

View Article
November 2018
4 Reads

Results of Duodenopancreatic Reoperations in Multiple Endocrine Neoplasia Type 1.

World J Surg 2018 Oct 4. Epub 2018 Oct 4.

Department of Visceral-, Thoracic- and Vascular Surgery, Philipps University of Marburg, Baldingerstr, 35043, Marburg, Germany.

Background: To evaluate the outcome of duodenopancreatic reoperations in patients with multiple endocrine neoplasia type 1 (MEN1).

Methods: MEN1 patients who underwent reoperations for duodenopancreatic neuroendocrine neoplasms (dpNENs) were retrieved from a prospective database and retrospectively analyzed.

Results: Twelve of 101 MEN1 patients underwent up to three reoperations, resulting in a total of 18 reoperations for dpNEN recurrence. Read More

View Article
October 2018
12 Reads

Multiple Endocrine Neoplasia Type 1: A Case Report With Review of Imaging Findings.

Ochsner J 2018 ;18(2):170-175

Department of Radiology, Ochsner Clinic Foundation, New Orleans, LA.

Background: Multiple endocrine neoplasia type 1 (MEN1) is a rare, autosomal dominant inherited syndrome caused by mutations in the MEN1 tumor suppressor gene. The diagnosis is defined clinically by the presence of 2 or more primary MEN1 tumors (parathyroid, anterior pituitary, and pancreatic islet). We describe the case of a patient who presented with classic history and imaging findings for MEN1. Read More

View Article
January 2018
2 Reads

Gastrinomas: Medical or Surgical Treatment.

Endocrinol Metab Clin North Am 2018 09;47(3):577-601

Digestive Diseases Branch, NIDDK, National Institutes of Health, Building 10, Room 9C-103, Bethesda, MD 20892-1804, USA. Electronic address:

This article reviews the role of surgical and medical management in patients with Zollinger-Ellison syndrome (ZES) due to a gastrin-secreting neuroendocrine tumor (gastrinoma). It concentrates on the status at present but also briefly reviews the changes over time in treatment approaches. Generally, surgical and medical therapy are complementary today; however, in some cases, such as patients with ZES and multiple endocrine neoplasia type 1, the treatment approach remains controversial. Read More

View Article
September 2018
3 Reads

Large primary hepatic gastrinoma in young patient treated with trisegmentectomy: A case report and review of the literature.

World J Hepatol 2018 Jul;10(7):517-522

Departamento de Gastroenterologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403, Brazil.

Primary hepatic gastrinoma is a rare disease, with fewer than 40 cases reported in the medical literature. Because it is located in an organ in which metastases are common, its diagnosis is difficult. We report a case of a 19 years old male patient with a history of gastric ulcers since the age of nine. Read More

View Article
July 2018
3 Reads

Bringing SASI back: Single session selective arterial secretin injection and transarterial embolization of intrahepatic pancreatic neuroendocrine metastasis in a MEN-1 patient.

Radiol Case Rep 2018 Apr 3;13(2):333-335. Epub 2018 Feb 3.

Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health Systems, 1500 East Medical Center Dr, Ann Arbor, MI 48109, USA.

SASI (selective arterial secretin injection) is a form of ASVS (arterial stimulation and venous sampling) used to localize pancreatic gastrinomas. This report aims to review the protocol for SASI and demonstrate its utility in localizing functional and nonfunctional gastrinomas. Even if a patient has a pancreatic mass and a laboratory profile fitting a specific endocrine syndrome, these may or may not be associated as has been previously demonstrated with adrenal vein sampling. Read More

View Article
April 2018
4 Reads

Gastrinoma and Zollinger-Ellison syndrome in canids: a literature review and a case in a Mexican gray wolf.

J Vet Diagn Invest 2018 Jul 2;30(4):584-588. Epub 2018 Jun 2.

Animal Health Institute, Department of Pathology and Population Medicine, Midwestern University, Glendale, AZ (Struthers, Wong).

Gastrinoma, an infrequent diagnosis in middle-aged dogs, occurs with nonspecific gastrointestinal morbidity. Laboratory tests can yield a presumptive diagnosis, but definitive diagnosis depends on histopathology and immunohistochemistry. We describe a malignant pancreatic gastrinoma with lymph node metastases and corresponding Zollinger-Ellison syndrome in a Mexican gray wolf ( Canis lupus baileyi) and review this endocrine neoplasm in domestic dogs. Read More

View Article
July 2018
2 Reads

The appropriate use of proton-pump inhibitors.

Minerva Med 2018 Oct 31;109(5):386-399. Epub 2018 May 31.

Gastrointestinal Unit, Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy.

The introduction of proton-pump inhibitors (PPIs) into clinical practice since about thirty years has greatly improved our therapeutic approach to acid-related diseases for their well recognized efficacy and safety. Accordingly, the role of surgery has been enormously reduced in this field. The main indications for PPI use are universally acknowledged by many scientific societies and are the following: treatment of gastroesophageal reflux disease in its various forms and complications, eradication of H. Read More

View Article
October 2018
6 Reads

Management of functional neuroendocrine tumors of the pancreas.

Authors:
Kjell Öberg

Gland Surg 2018 Feb;7(1):20-27

Department of Medical Sciences, Endocrine Oncology, Uppsala University Hospital, Uppsala, Sweden.

Pancreatic neuroendocrine tumors (pNETs) constitute a heterogenous group of malignancies with varying clinical presentation, tumor biology and prognosis. The incidence of pNETs has steadily increased during the last decades with an estimated incidence 2012 of 4.8/100,000. Read More

View Article
February 2018
8 Reads

Old and New Gut Hormone, Gastrin and Acid Suppressive Therapy.

Digestion 2018 27;97(4):340-344. Epub 2018 Mar 27.

Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, Kurashiki, Japan.

Gastrin acts physiologically as a gut hormone to stimulate acid secretion after meal and as a cell-growth factor of oxyntic mucosa. Increase in serum gastrin level happens under various conditions including Zollinger-Ellison syndrome, antral G cell hyperplasia, autoimmune gastritis, atrophic gastritis, renal failure, vagotomy, Helicobacter pylori infection and acid suppressive therapy. As acid suppressive therapy causes hypergastrinemia, the association between acid suppressive therapy and gastric neuroendocrine cell tumor (NET) has been discussed during the past 30 years. Read More

View Article
September 2018
4 Reads

Prospective Evaluation of Results of Reoperation in Zollinger-Ellison Syndrome.

Ann Surg 2018 Apr;267(4):782-788

Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.

Objective: To determine the role of reoperation in patients with persistent or recurrent Zollinger-Ellison Syndrome (ZES).

Background: Approximately, 0% to 60% of ZES patients are disease-free (DF) after an initial operation, but the tumor may recur.

Methods: A prospective database was queried. Read More

View Article
April 2018
7 Reads

A Rare Cause of Abdominal Pain and Mass in an 18-Year-Old Patient: A Diagnostic Dilemma.

Gastroenterology Res 2018 Feb 23;11(1):75-78. Epub 2018 Feb 23.

Department of Medicine, Bronx Lebanon Hospital Center, Bronx, NY 10457, USA.

We present a case of an 18-year-old male who presented with complains of abdominal pain, nausea and vomiting for 2 years. An esophagogastroduodenoscopy (EGD) revealed a 3 mm nodule on the lesser curvature of the stomach and prominent gastric folds. Biopsy of the nodule revealed a well-differentiated neuroendocrine tumor (NET) in lamina prop with focal extension into muscularis mucosa consistent with a gastric carcinoid. Read More

View Article
February 2018
5 Reads

Introduction and practical approach to exocrine pancreatic insufficiency for the practicing clinician.

Int J Clin Pract 2018 Feb 5;72(2). Epub 2018 Feb 5.

Division of Gastroenterology, Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.

Aims: In exocrine pancreatic insufficiency (EPI), the quantity and/or activity of pancreatic digestive enzymes are below the levels required for normal digestion, leading to maldigestion and malabsorption. Diagnosis of EPI is often challenging because the characteristic signs and symptoms overlap with those of other gastrointestinal conditions. Additionally, there is no single convenient, or specific diagnostic test for EPI. Read More

View Article
February 2018
11 Reads

Diagnosis of Zollinger-Ellison syndrome in the era of PPIs, faulty gastrin assays, sensitive imaging and limited access to acid secretory testing.

Int J Endocr Oncol 2017 11;4(4):167-185. Epub 2017 Oct 11.

Digestive Diseases Branch, NIDDK, NIH, Bethesda, Maryland, 20817, USA.

In recent years the diagnosis of Zollinger-Ellison syndrome (ZES) has become increasingly controversial with several new approaches and criteria proposed, differing from the classical biochemical criterion of inappropriate hypergastrinemia (i.e., hypergastrinemia in the presence of hyperchlorhydria) (Table 1). Read More

View Article
October 2017
10 Reads

Going from A to Z.

N Engl J Med 2018 01;378(1):73-79

From the Department of Medicine, Johns Hopkins Hospital and Johns Hopkins University School of Medicine, Baltimore (D.A., D.F., R.M.); and the Department of Medicine, University of California, San Francisco, and the Medical Service, San Francisco Veterans Affairs Medical Center - both in San Francisco (G.D., K.R.F.).

View Article
January 2018
17 Reads

[Functional diagnostics in endocrinology].

Internist (Berl) 2018 01;59(1):38-47

Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Campus Innenstadt, Ziemssenstraße 1, 80366, München, Deutschland.

When investigating many endocrinological diseases, basal laboratory parameters are not sufficient to distinguish between physiological and pathological hormone secretion. Functional diagnostics plays a decisive role in this context. Stimulation and suppression tests are used depending on whether under- or over-function needs to be diagnosed. Read More

View Article
January 2018
9 Reads

Hormone secreting gastro-entero-pancreatic neuroendocrine neoplasias (GEP-NEN): When to consider, how to diagnose?

Rev Endocr Metab Disord 2017 12;18(4):393-410

Schwerpunkt Endokrinologie und Stoffwechselerkrankungen, I. Medizinischen Klinik und Poliklinik; ENETS center of excellence, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstrasse 1, 55101, Mainz, Germany.

Neuroendocrine neoplasms of the digestive system (GEP-NEN) represent a heterogeneous group of malignancies with various clinical presentation and prognosis. GEP-NENs can potentially affect all organs of the gastrointestinal tract; characteristically they share the biological property to produce and secrete peptides and neuroamines. About 30% of GEP-NENs are hormonally active and can cause specific clinical syndromes. Read More

View Article
December 2017
9 Reads

Surgical Therapy of Sporadic Pancreatic Neuroendocrine Neoplasias G1/G2.

Visc Med 2017 Oct 4;33(5):344-350. Epub 2017 Oct 4.

Department of Visceral-, Thoracic- and Vascular Surgery, University Hospital Marburg, Marburg, Germany.

Background: Pancreatic neuroendocrine neoplasias (pNENs) are uncommon but fascinating tumors with an annual incidence of 1 per 100,000 people. pNENs present either as functional tumors, causing specific hormonal syndromes like Zollinger-Ellison syndrome (ZES) or organic hyperinsulinism, or as non-functional pancreatic tumors (NF-pNENs). The natural history of pNENs is highly variable. Read More

View Article
October 2017
6 Reads

The Zollinger-Ellison syndrome: is there a role for somatostatin analogues in the treatment of the gastrinoma?

Endocrine 2018 04 10;60(1):15-27. Epub 2017 Oct 10.

Thyroid and Parathyroid Surgery Unit, Istituto Nazionale per lo studio e la cura dei tumori "Fondazione G. Pascale" - IRCCS, Naples, Italy.

Purpose: Analyze the role of somatostatin analogues (SSAs) in the treatment of sporadic and MEN1-related gastrinomas, trying to define whether recent trials have changed the landscape of gastrinoma therapy.

Methods: We evaluate the rationale of SSA use in the treatment of gastrinomas, summarize the current literature concerning the effect of SSAs on the control of Zollinger-Ellison syndrome (ZES) and gastrinomas tumor progression and discuss their role in the most recent guidelines.

Results: The medical treatment of gastrinoma and related ZES is aimed at controlling acid hypersecretion and tumor progression, in inoperable patients. Read More

View Article
April 2018
31 Reads

Diagnosis and management of Zollinger-Ellison syndrome in 2018.

Minerva Endocrinol 2018 Jun 25;43(2):212-220. Epub 2017 Sep 25.

Department of Gastroenterology and Digestive Endoscopy, AOU Città della Salute e della Scienza, University of Turin, Turin, Italy.

Zollinger-Ellison syndrome (ZES) is a clinical syndrome characterized by gastric acid hypersecretion due to the ectopic secretion of gastrin by a gastrinoma, a neuroendocrine tumor (NET) which mostly develops in the duodenum and in the pancreas. This syndrome was first described by Zollinger and Ellison in 1964; if left untreated, ZES can lead to multiple complications mainly due to gastric hypersecretion and some patients can suffer from the complications of an advanced metastatic disease. Although its clinical features are considered typical, the diagnosis of ZES is often challenging for the clinician. Read More

View Article
June 2018
35 Reads

Catching the Zebra: Clinical Pearls and Pitfalls for the Successful Diagnosis of Zollinger-Ellison Syndrome.

Dig Dis Sci 2017 09 3;62(9):2258-2265. Epub 2017 Aug 3.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Zollinger-Ellison syndrome (ZES) results from an ectopic gastrin-secreting tumor leading to peptic ulcer disease, reflux, and chronic diarrhea. While early recognition portends an excellent prognosis with >80% survival at 15 years, symptoms are often nonspecific making the diagnosis difficult to establish. Diagnosis involves a series of tests, including fasting gastrin, gastric pH, chromogranin A, and secretin stimulation. Read More

View Article
September 2017
15 Reads

The Effect of H Receptor Antagonist in Acid Inhibition and Its Clinical Efficacy.

Korean J Gastroenterol 2017 Jul;70(1):4-12

Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Korea.

The first histamine H receptor antagonists (HRAs) were developed in the early 1970s. They played a dominant role in treating peptic ulcer disease and gastroesophageal reflux disease (GERD). HRAs block the production of acid by H, K-ATPase at the parietal cells and produce gastric luminal anacidity for varying periods. Read More

View Article
July 2017
11 Reads

Zollinger-Ellison Syndrome in a 12-year-old Child.

J Indian Assoc Pediatr Surg 2017 Jul-Sep;22(3):168-169

Department of Pediatric Surgery, Dr. D. Y. Patil Hospital and Research Centre, Navi Mumbai, Maharashtra, India.

The syndrome described by Zollinger and Ellison in 1955 is a rare clinical entity which is even rarer in children. This report describes a 12-year-old boy who presented with refractory peptic ulcer disease which was finally diagnosed to be due to a gastrinoma and was successfully treated. Read More

View Article
July 2017
8 Reads

Gastrointestinal: Zollinger-Ellison Syndrome: A rare cause of chronic diarrhea and abdominal pain.

J Gastroenterol Hepatol 2017 Jul;32(7):1281

Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA.

View Article
July 2017
4 Reads

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

View Article
May 2017
36 Reads

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

View Article
April 2017
7 Reads

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

View Article
February 2017
12 Reads

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

View Article
March 2017
13 Reads

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

View Article
March 2017
21 Reads

[Neuroendocrine neoplasia of the stomach : What is new?]

Pathologe 2017 Mar;38(2):98-104

Pathologisches Institut, Ludwig-Maximilians-Universität (LMU), Thalkirchnerstr. 36, 80337, München, Deutschland.

Introduction: Neuroendocrine Neoplasms are classified according to the new WHO classification in (1.) well differentiated neuroendocrine tumors G1 (NET G1, Ki67 ≤ 2 or mitosis count <2) and (2.) well differentiated neuroendocrine tumors G2 (NET G2, Ki67 3-20 or mitosis count 2-20) and (3. Read More

View Article
March 2017
6 Reads

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

View Article
December 2016
14 Reads

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

View Article
December 2016
5 Reads

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

View Article
May 2017
7 Reads

[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

View Article
November 2016
50 Reads

[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

View Article
November 2016
5 Reads

Operation for insulinomas in multiple endocrine neoplasia type 1: When pancreatoduodenectomy is appropriate.

Surgery 2017 03 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

View Article
March 2017
62 Reads

Inhibiting the proton pump: mechanisms, benefits, harms, and questions.

BMC Med 2016 11 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

View Article
November 2016
9 Reads

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 11 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

View Article
November 2016
24 Reads

The appropriate use of proton pump inhibitors (PPIs): Need for a reappraisal.

Eur J Intern Med 2017 Jan 23;37:19-24. Epub 2016 Oct 23.

Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.

The advent of powerful acid-suppressive drugs, such as proton pump inhibitors (PPIs), has revolutionized the management of acid-related diseases and has minimized the role of surgery. The major and universally recognized indications for their use are represented by treatment of gastro-esophageal reflux disease, eradication of Helicobacter pylori infection in combination with antibiotics, therapy of H. pylori-negative peptic ulcers, healing and prophylaxis of non-steroidal anti-inflammatory drug-associated gastric ulcers and control of several acid hypersecretory conditions. Read More

View Article
January 2017
10 Reads

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

View Article
November 2016
9 Reads

Per-oral endoscopic tunneling for restoration of the esophagus: a novel endoscopic submucosal dissection technique for therapy of complete esophageal obstruction.

Gastrointest Endosc 2017 Apr 7;85(4):722-727. Epub 2016 Sep 7.

University of Florida, Gainesville, Florida, USA.

Background And Aims: Total aphagia from complete esophageal obstruction (CEO) can be seen in patients with head-neck or thoracic malignancies undergoing chemoradiation or surgery. Combined antegrade and retrograde endoscopy (via gastrostomy tube [G-tube] tract) is often performed for esophageal reconstruction but is limited by the length of the obstructed esophagus. We describe per-oral endoscopic tunneling for restoration of the esophagus (POETRE) for patients with longer segments of esophageal obstruction. Read More

View Article
April 2017
10 Reads

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

View Article
August 2016
7 Reads

Drug-Induced Vitamin B Deficiency: A Focus on Proton Pump Inhibitors and Histamine-2 Antagonists.

J Pharm Pract 2017 Dec 12;30(6):639-642. Epub 2016 Aug 12.

3 Presbyterian College School of Pharmacy, Clinton, SC, USA.

Objective: To review primary literature of gastric acid suppressive agents and vitamin B deficiency.

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

View Article
December 2017
12 Reads