Endoscopic diagnosis of a duodenal gastrinoma

Wadas, Darrell D.; Pg, Foutch; Manne, Rao K.; Sanowski, Robert A.

doi:10.1016/s0016-5107(88)71412-1

Cited by 6 publications

(1 citation statement)

References 3 publications

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“…The reported endoscopic findings of duodenal gastrinomas include: volcano shaped, 25 ulcerated and round, 26 bilobed nodule with central depression, 27 donut-shaped, 28 and raised sessile with central depression. 29 It is important to carefully examine the duodenal bulb by endoscopy and EUS while keeping in mind the characteristic gross appearence of duodenal gastrinomas.…”

Section: Discussionmentioning

confidence: 99%

Duodenal gastrinoma--clinical features and usefulness of selective arterial secretin injection test

Takasu

Shimosegawa

Fukudo

et al. 1998

Journal of Gastroenterology

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Duodenal gastrinoma is recognized as a relatively common cause of Zollinger-Ellison syndrome, but its clinical and biological features are not well known. Here we report a case of duodenal gastrinoma with lymph node metastasis which was confirmed by pathology examinations. Hypergastrinemia and gastric acid hypersecretion were documented, but the secretin test showed negative results. An enlarged peripancreatic lymph node lying close to the pancreas head was the only positive finding on preoperative imaging studies. The results of the selective arterial secretin injection (SASI) test suggested that the primary tumor was located in the gastrinoma triangle. Finally, surgical exploration was carried out and a submucosal tumor, approximately 15 mm in size, was detected by intraoperative palpation at the posterior wall of the proximal portion of the duodenum. Intraoperative pathology examination demonstrated metastases to regional lymph nodes. The present case calls attention to the unique features of duodenal gastrinomas, which differ from those of pancreatic origin: a highly malignant potential for its small size, and submucosal location in the proximal duodenum. The SASI test is recommended for assessing the location of a primary lesion if it cannot be identified by various conventional imaging studies.

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Section: Discussionmentioning

confidence: 99%