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Síndrome de Zollinger-Ellison

Última revisão: 14 Sep 2025
Última atualização: 22 May 2025

Resumo

Definição

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • úlcera péptica refratária ou recorrente
  • diarreia
Full details

Other diagnostic factors

  • dor abdominal epigástrica
  • doença do refluxo gastroesofágico
  • esteatorreia
  • hemorragia digestiva
  • dor óssea
Full details

Risk factors

  • neoplasia endócrina múltipla tipo 1 (NEM1)
Full details

Diagnostic investigations

1st investigations to order

  • gastrina sérica em jejum
  • pH gástrico
Full details

Investigations to consider

  • teste de estimulação de secretina
  • teste de infusão de cálcio
  • teste do glucagon
  • tomografia computadorizada (TC) abdominal
  • ressonância nuclear magnética (RNM) abdominal
  • cintilografia dos receptores da somatostatina (CRS)
  • PET com Gálio (Ga)-68 DOTATATE
  • ultrassonografia endoscópica (USE)
  • endoscopia digestiva alta (EDA)
  • tomografia computadorizada (TC) do tórax
  • teste genético para neoplasia endócrina múltipla tipo 1 (NEM1)
Full details

Treatment algorithm

ACUTE

doença localizada: esporádica

Doença localizada: NEM1

doença metastática: predominantemente hepática

doença metastática: extra-hepática

Contributors

Authors

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

Disclosures

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.

Acknowledgements

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.

Disclosures

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

Peer reviewers

Peter Draganov, MD

Associate Professor of Medicine Division

Gastroenterology, Hepatology and Nutrition

University of Florida

Gainesville

FL

Disclosures

PD declares that he has no competing interests.

Petros Perros, BSc, MBBS, MD, FRCP

Consultant Endocrinologist

Freeman Hospital

Newcastle-Upon-Tyne Hospitals Trust

UK

Disclosures

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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.Full text  Abstract

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

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  Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
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