Last reviewed: 25 Sep 2021
Last updated: 26 Oct 2018

Summary

Definition

History and exam

Other diagnostic factors

  • middle age
  • headache
  • weight loss
  • poor skin turgor
  • flushing
  • history of multiple endocrine neoplasia type 1 (MEN1)

Risk factors

  • multiple endocrine neoplasia type 1 (MEN1)
  • middle age

Diagnostic investigations

1st investigations to order

  • serum potassium
  • serum bicarbonate
  • serum calcium
  • serum glucose
  • vasoactive intestinal peptide (VIP) radioimmunoassay
  • liver function tests

Investigations to consider

  • arterial blood gas analysis
  • gastric pH monitoring
  • chromogranin A
  • pancreatic polypeptide
  • ultrasound
  • contrast-enhanced thin-slice computed tomography scan of abdomen
  • contrast-enhanced magnetic resonance imaging (MRI) of abdomen
  • somatostatin receptor scintigraphy
  • endoscopic ultrasound
  • operative exploration
  • intraoperative ultrasound
  • positron emission tomography (PET)/computed tomography (CT)

Treatment algorithm

Contributors

Authors

Harish Lavu, MD, FACS
Harish Lavu

Associate Professor of Surgery

Jefferson Medical College

Thomas Jefferson University

Philadelphia

PA

Disclosures

HL declares that he has no competing interests.

Charles J. Yeo, MD, FACS
Charles J. Yeo

The Samuel D. Gross Professor and Chair

Department of Surgery

Jefferson Medical College

Thomas Jefferson University

Philadelphia

PA

Disclosures

CJY declares that he has no competing interests.

Peer reviewers

Jaime Ruiz-Tovar, MD

Fellow of the Spanish Association of Surgeons (AEC)

Department of Surgery

University Hospital Ramon y Cajal

Madrid

Spain

Disclosures

JRT declares that he has no competing interests.

Christopher Wolfgang, MD, PhD, FACS

Assistant Professor of Surgery and Oncology

Cameron Division of Surgical Oncology

The Sol Goldman Pancreatic Cancer Research Center

Johns Hopkins University

Baltimore

MD

Disclosures

CW declares that he has no competing interests.

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