小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 难治性或复发性消化性溃疡病
- 腹泻
其他诊断因素
- 上腹痛
- 胃食管反流病
- 脂肪痢
- 消化道出血
- 骨痛
危险因素
- 1 型多发性内分泌肿瘤 (MEN)
诊断性检查
首要检查
- 空腹血清胃泌素
- 基础和最大酸排出量
- 肠促胰液素输液试验
- 钙输液试验
需考虑的检查
- 上消化道内镜检查
- 超声内镜 (EUS)
- 肝脏 MRI
- 肝脏螺旋 CT
- 生长抑素受体闪烁显像 (SRS)
- 镓 (Ga)-68 DOTATATE
- 胰高血糖素试验
- 血清Ghrelin
治疗流程
局部疾病:散发型
局部疾病:MEN1 综合征
转移性疾病:主要为肝脏
转移性疾病:肝外
撰稿人
作者
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
利益声明
JRP is an author of a number of references cited in this topic.
鸣谢
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. DG, JB, DO, and HW declare that they have no competing interests.
同行评议者
Peter Draganov, MD
Associate Professor of Medicine Division
Gastroenterology, Hepatology and Nutrition
University of Florida
Gainesville
FL
利益声明
PD declares that he has no competing interests.
Petros Perros, BSc, MBBS, MD, FRCP
Consultant Endocrinologist
Freeman Hospital
Newcastle-Upon-Tyne Hospitals Trust
UK
利益声明
PP declares that he has no competing interests.
鉴别诊断
- 萎缩性胃炎
- 幽门螺杆菌感染导致的消化性溃疡病
- 特发性胃酸分泌过多
更多 鉴别诊断指南
- 消化道内镜操作的知情同意
- 与 EUS 和 EUS 引导下操作相关的不良事件
更多 指南患者教育信息
消化性溃疡
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