A 41-Year-Old Man with Two Types of Metachronous Peptic Ulcer Complication due to Zollinger-Ellison Syndrome—Regression of Pancreatic Primary after Chemoembolization of Hepatic Metastases: A Case Report

Introduction. Gastrinoma should be suspected when the peptic ulcer(s) is postbulbar, multiple, refractory, or recurrent, or ulcer is associated with nephrolithiasis, hypocalcaemia, or erosive esophagitis. The majority of gastrinomas are malignant. Case Presentation. The patient is a 41-year-old Iran...

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Main Authors: Seyed Saeid Sarkeshikian, Mohammad Reza Ghadir
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2011/156937
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author Seyed Saeid Sarkeshikian
Mohammad Reza Ghadir
author_facet Seyed Saeid Sarkeshikian
Mohammad Reza Ghadir
author_sort Seyed Saeid Sarkeshikian
collection DOAJ
description Introduction. Gastrinoma should be suspected when the peptic ulcer(s) is postbulbar, multiple, refractory, or recurrent, or ulcer is associated with nephrolithiasis, hypocalcaemia, or erosive esophagitis. The majority of gastrinomas are malignant. Case Presentation. The patient is a 41-year-old Iranian man who has been in good health until 36 months ago when duodenal perforation and two bouts of upper GI bleeding (GIB), each two months apart occurred. He also mentioned mild watery diarrhoea and decreased appetite. Serum gastrin level was elevated. Abdominal CT scan revealed pancreatic mass and three enhancing hepatic masses. CT-guided pancreatic biopsy revealed monotonous cells. Chemoembolization of hepatic metastases was done. New ct images 6 months later showed nearly total regressed hepatic and pancreatic lesions. Conclusion. Beside previously defined situations that take gastrinoma into account as the etiology of PUD, accumulation of PUD complications is highly suggestive of Zollinger-Ellisone syndrome (ZES). Regression of pancreatic primary after chemoembolization of hepatic metastases is unexplainable at the present time.
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spelling doaj-art-7b056643a4de4b6da76d9483c0e8395d2025-08-20T02:07:02ZengWileyCase Reports in Medicine1687-96271687-96352011-01-01201110.1155/2011/156937156937A 41-Year-Old Man with Two Types of Metachronous Peptic Ulcer Complication due to Zollinger-Ellison Syndrome—Regression of Pancreatic Primary after Chemoembolization of Hepatic Metastases: A Case ReportSeyed Saeid Sarkeshikian0Mohammad Reza Ghadir1Gastroenterology Division, Shahid Beheshti Hospital, School of Medicine, Qom Medical University, Qom, IranGastroenterology Division, Shahid Beheshti Hospital, School of Medicine, Qom Medical University, Qom, IranIntroduction. Gastrinoma should be suspected when the peptic ulcer(s) is postbulbar, multiple, refractory, or recurrent, or ulcer is associated with nephrolithiasis, hypocalcaemia, or erosive esophagitis. The majority of gastrinomas are malignant. Case Presentation. The patient is a 41-year-old Iranian man who has been in good health until 36 months ago when duodenal perforation and two bouts of upper GI bleeding (GIB), each two months apart occurred. He also mentioned mild watery diarrhoea and decreased appetite. Serum gastrin level was elevated. Abdominal CT scan revealed pancreatic mass and three enhancing hepatic masses. CT-guided pancreatic biopsy revealed monotonous cells. Chemoembolization of hepatic metastases was done. New ct images 6 months later showed nearly total regressed hepatic and pancreatic lesions. Conclusion. Beside previously defined situations that take gastrinoma into account as the etiology of PUD, accumulation of PUD complications is highly suggestive of Zollinger-Ellisone syndrome (ZES). Regression of pancreatic primary after chemoembolization of hepatic metastases is unexplainable at the present time.http://dx.doi.org/10.1155/2011/156937
spellingShingle Seyed Saeid Sarkeshikian
Mohammad Reza Ghadir
A 41-Year-Old Man with Two Types of Metachronous Peptic Ulcer Complication due to Zollinger-Ellison Syndrome—Regression of Pancreatic Primary after Chemoembolization of Hepatic Metastases: A Case Report
Case Reports in Medicine
title A 41-Year-Old Man with Two Types of Metachronous Peptic Ulcer Complication due to Zollinger-Ellison Syndrome—Regression of Pancreatic Primary after Chemoembolization of Hepatic Metastases: A Case Report
title_full A 41-Year-Old Man with Two Types of Metachronous Peptic Ulcer Complication due to Zollinger-Ellison Syndrome—Regression of Pancreatic Primary after Chemoembolization of Hepatic Metastases: A Case Report
title_fullStr A 41-Year-Old Man with Two Types of Metachronous Peptic Ulcer Complication due to Zollinger-Ellison Syndrome—Regression of Pancreatic Primary after Chemoembolization of Hepatic Metastases: A Case Report
title_full_unstemmed A 41-Year-Old Man with Two Types of Metachronous Peptic Ulcer Complication due to Zollinger-Ellison Syndrome—Regression of Pancreatic Primary after Chemoembolization of Hepatic Metastases: A Case Report
title_short A 41-Year-Old Man with Two Types of Metachronous Peptic Ulcer Complication due to Zollinger-Ellison Syndrome—Regression of Pancreatic Primary after Chemoembolization of Hepatic Metastases: A Case Report
title_sort 41 year old man with two types of metachronous peptic ulcer complication due to zollinger ellison syndrome regression of pancreatic primary after chemoembolization of hepatic metastases a case report
url http://dx.doi.org/10.1155/2011/156937
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