BACKGROUND: An elderly male with underlying Hepatocellular carcinoma came with history of fall with head and ear trauma, vomiting, abdominal pain, fatigue. Patient died within hours due to Septic shock Blood culture grew Non O1/O139 Vibrio cholerae which was later found to be non-toxigenic. This was a lethal case of non-O1/non-O139 V. cholerae sepsis and we focus on the dilemmas in identification and management of this rare bacterium.
Introduction: Gastrinoma is a rare gastrin secreting neuroendocrine tumor. Clinical manifestations are nonspecific gastrointestinal (GI) symptoms or as Zollinger Ellison Syndrome(ZES) which often delays the diagnosis in majority of patients. Hence a high clinical index of suspicion is warranted in patients who present with nonspecific GI symptoms to rule out gastrinoma. Case report: We report a case of 55 year old female who presented with long standing dyspepsia and chronic diarrhoea and was diagnosed with Sporadic Duodenal Gastrinoma on detailed evaluation. She was treated with surgical resection and pathologically diagnosed as well differentiated neuroendocrine tumor, Gastrinoma-grade I after IHC analysis. Patient was relieved of her symptoms and became eugastrinemic after surgery. Conclusion: Any patient with refractory dyspepsia associated with long standing non specific abdominal symptoms should be evaluated for Gastrinoma and treated accordingly to avoid misdiagnosis and complications in the long run.
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