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Síndrome de Zollinger-Ellison

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisão: 13 Sep 2025
Última atualização: 22 May 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • presença de fatores de risco
  • úlcera péptica refratária ou recorrente
  • diarreia
Detalhes completos

Outros fatores diagnósticos

  • dor abdominal epigástrica
  • doença do refluxo gastroesofágico
  • esteatorreia
  • hemorragia digestiva
  • dor óssea
Detalhes completos

Fatores de risco

  • neoplasia endócrina múltipla tipo 1 (NEM1)
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • gastrina sérica em jejum
  • pH gástrico
Detalhes completos

Investigações a serem consideradas

  • 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)
Detalhes completos

Algoritmo de tratamento

AGUDA

doença localizada: esporádica

Doença localizada: NEM1

doença metastática: predominantemente hepática

doença metastática: extra-hepática

Colaboradores

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.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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