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Zollinger-Ellison syndrome

Última revisão: 18 Aug 2025
Última atualização: 22 May 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • refractory or recurrent peptic ulcer disease
  • diarrhea
Detalhes completos

Outros fatores diagnósticos

  • epigastric abdominal pain
  • gastroesophageal reflux disease
  • steatorrhea
  • gastrointestinal bleed
  • bone pain
Detalhes completos

Fatores de risco

  • multiple endocrine neoplasia type 1 (MEN1)
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • fasting serum gastrin
  • gastric pH
Detalhes completos

Investigações a serem consideradas

  • secretin stimulation test
  • calcium infusion test
  • glucagon test
  • abdominal CT scan
  • abdominal MRI scan
  • somatostatin receptor scintigraphy (SRS)
  • gallium(Ga)-68 DOTATATE PET
  • endoscopic ultrasound (EUS)
  • esophagogastroduodenoscopy (EGD)
  • chest CT
  • genetic testing for multiple endocrine neoplasia type 1 (MEN1)
Detalhes completos

Algoritmo de tratamento

AGUDA

localized disease: sporadic

localized disease: MEN1

metastatic disease: predominantly hepatic

metastatic disease: extrahepatic

Colaboradores

Autores

Joseph R. Pisegna, MD

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

Declarações

JRP is an author of a number of references cited in this topic. JRP has received a grant from Takeda Pharmaceuticals and is a speaker for Phathom Pharmaceuticals and AbbVie.

Agradecimentos

Dr Joseph R. Pisegna would like to gratefully acknowledge Dr Deepinder Goyal, Dr Jihane Benhammou, Dr David Oh, and Dr Hank Wang, previous contributors to this topic.

Declarações

DG, JB, DO, and HW declare that they have no competing interests.

Revisores

Peter Draganov, MD

Associate Professor of Medicine Division

Gastroenterology, Hepatology and Nutrition

University of Florida

Gainesville

FL

Declarações

PD declares that he has no competing interests.

Petros Perros, BSc, MBBS, MD, FRCP

Consultant Endocrinologist

Freeman Hospital

Newcastle-Upon-Tyne Hospitals Trust

UK

Declarações

PP declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Falconi M, Eriksson B, Kaltsas G, et al. ENETS consensus guidelines update for the management of patients with functional pancreatic neuroendocrine tumors and non-functional pancreatic neuroendocrine tumors. Neuroendocrinology. 2016;103(2):153-71.Texto completo  Resumo

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: neuroendocrine and adrenal tumors [internet publication].Texto completo

Kunz PL, Reidy-Lagunes D, Anthony LB, et al. Consensus guidelines for the management and treatment of neuroendocrine tumors. Pancreas. 2013 May;42(4):557-77.Texto completo  Resumo

Pavel M, Öberg K, Falconi M, et al. Gastroenteropancreatic neuroendocrine neoplasms: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020 Jul;31(7):844-60.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Diagnósticos diferenciais

    • Atrophic gastritis
    • Peptic ulcer disease from Helicobacter pylori infection
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  • Guidelines

    • NCCN clinical practice guidelines in oncology: neuroendocrine and adrenal tumors
    • Clinical practice update on management of subepithelial lesions encountered during routine endoscopy: expert review
    Mais Guidelines
  • Patient information

    Pancreatic cancer

    Peptic ulcers

    More Patient information
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