Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors reported a case of giant solitary pancreatic gastrinoma. A 29-year-old woman complaining of upper abdominal pain and loss of weight of 6 months duration. Four months later she noticed moving abdominal tumor. At the surgery a tumor was identified on pancreatic body measuring 20 centimeters of dimension and it was completely removed. A partial pancreatectomy with pancreatic tail preservation was performed in addition to this the Wirsung duct was joined on pancreatic head. No abdominal metastasis was found. The gastrointestinal transit was re-established by end-to-side Roux-en-Y jejunum-pancreatic anastomosis. The final diagnosis was confirmed by immunohistochemical test (immunoperoxidase). The follow-up was made until 40th postoperative month and after surgery the plasma level of gastrin was 120 pg/ml but at present day is normal. The authors concluded that it was a benign giant solitary pancreatic gastrinoma.
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PMID:[Giant solitary gastrinoma of the pancreas]. 184 39

Gastrinomas are rare neuroendocrine tumours. A 9-year-old boy who initially presented with recurrent upper abdominal pain and was managed as hyperacidity syndrome was later diagnosed to have a primary, retroperitoneal, extra pancreatic gastrinoma after an asymptomatic period of 6 years is presented. At the second presentation, the contrast-enhanced CT revealed an epigastric mass and serum gastrin was grossly elevated. A complete excision of the mass was done; histopathological evaluation showed a well-differentiated neuroendocrine tumour. At a year follow up, the child is asymptomatic and the review imaging and serum gastrin levels are normal.
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PMID:Giant gastrinoma in a child: case report and review. 1867 89

The role of operation in patients with Multiple Endocrine Neoplasia Type 1 (MEN-1) and Zollinger-Ellison Syndrome (ZES) is controversial. Our institutional bias for this disease has, in general, been towards aggressive imaging and operative removal of localized gastrinomas. Few studies have reported long-term outcomes in patients with MEN-1 and ZES. A single institution retrospective review of all patients with MEN-1 and ZES from 1970 to present was performed. Twelve patients were identified (median age = 37 years at diagnosis). The median follow-up was 18 years from diagnosis of ZES. Common symptoms associated with gastrinoma in these patients were diarrhea (n = 6), abdominal pain (n = 4), and nausea/vomiting (n = 4). Most commonly identified sites of gastrinoma were: pancreas (n = 10), duodenum (n = 4), lymph nodes (n = 3), and liver (n = 1). Fifteen celiotomies were performed in total (median = 1; range 0-3). Operative procedures performed included: distal pancreatectomy (n = 4), acid reducing procedure (n = 4), enucleation of pancreatic gastrinoma (n = 3), duodenal resection (n = 3), pancreaticoduodenectomy (n = 1), and other (n = 7). One patient had a transient biochemical cure after operation lasting 3 years. Only one patient in this series had documented liver metastases of gastrinoma and no patients expired of metastatic gastrinoma. There was one postoperative patient death, secondary to respiratory arrest thought to be a result of aspiration or pulmonary embolus. Three patients died of nondisease related causes, and seven patients were alive at the time of last follow-up. Operations rarely result in biochemical cures in patients with MEN-1 and ZES. In our experience, resection of localized gastrinomas often did not require extended surgical resection and were associated with excellent long-term outcomes.
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PMID:Long-term results of a selective surgical approach to management of Zollinger-Ellison syndrome in patients with MEN-1. 1972

A 42-year-old man, after remission of MALT lymphoma of the small intestine, was repeatedly hospitalized because of abdominal pain and severe dehydration caused by frequent vomiting and watery diarrhea. His symptoms would improve quickly every time when he was fasted and inserted a nasogastric tube. We were unable to find abnormalities on endoscopic examination and computed tomography. He was suspected to have gastrinoma because of active bleeding from a duodenal ulcer. High-level serum gastrin, endoscopic ultrasound, somatostatin receptor scintigraphy, and selective arterial calcium injection test were done. He was diagnosed with pancreatic gastrinoma in the pancreatic head by endoscopic ultrasound fine needle aspiration and subsequently underwent pancreatoduodenectomy. Histopathologic findings showed a 3-mm neuroendocrine tumor located in the duodenal submucosal layer. The presence of metastasis was confirmed in one of the peripancreatic lymph nodes. The pancreatic gastrinoma in the pancreatic head that we initially diagnosed was a lymph node metastasis behind the pancreas. Because additional resection was performed on the duodenum, we were able obtain a diagnosis of duodenal gastrinoma.
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PMID:[A case of difficult to diagnose duodenal gastrinoma]. 3277 88