Last reviewed: November 2017
Last updated: August  2016

Summary

Definition

History and exam

Key diagnostic factors

  • refractory or recurrent peptic ulcer disease
  • diarrhea

Other diagnostic factors

  • epigastric abdominal pain
  • gastroesophageal reflux disease
  • steatorrhea
  • GI bleed
  • bone pain

Risk factors

  • multiple endocrine neoplasia (MEN) type 1

Diagnostic investigations

1st investigations to order

  • fasting serum gastrin
  • acid output (basal and maximal)
  • secretin infusion test
  • calcium infusion test
Full details

Investigations to consider

  • upper GI endoscopy
  • endoscopic ultrasound (EUS)
  • MRI liver
  • spiral CT liver
  • somatostatin receptor scintigraphy (SRS)
  • gallium(Ga)-68 DOTATATE
  • glucagon test
  • serum ghrelin
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Professor of Medicine

Chief

Division of Gastroenterology, Hepatology, and Parenteral Nutrition

David Geffen School of Medicine at University of California

VA Greater Los Angeles Healthcare System

Department of Veterans Affairs

Los Angeles

CA

Disclosures

JRP is an author of a number of references cited in this monograph.

Fellow in Gastroenterology

Division of Digestive Diseases

UCLA

Los Angeles

CA

Disclosures

DG declares that he has no competing interests.

Dr Joseph R. Pisegna and Dr Deepinder Goyal would like to gratefully acknowledge Dr David Oh and Dr Hank Wang, the previous contributors to this monograph. DO and HW declare that they have no competing interests.

Peer reviewers VIEW ALL

Associate Professor of Medicine Division

Gastroenterology, Hepatology and Nutrition

University of Florida

Gainesville

FL

Disclosures

PD declares that he has no competing interests.

Consultant Endocrinologist

Freeman Hospital

Newcastle-Upon-Tyne Hospitals Trust

UK

Disclosures

PP declares that he has no competing interests.

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