Marked hypergastrinemia in gastric outlet obstruction.
We report a 45-year-old woman with chronic peptic ulcer disease and multiple episodes of bowel obstruction, who was admitted with gastric outlet obstruction. Because of gastric hypersecretion, a diagnosis of Zollinger-Ellison syndrome was suspected and an initial serum gastrin of 1,251 pg/ml supported this diagnosis. Subsequent evaluation failed to reveal a gastrinoma. A repeat serum gastrin level after 14 days of continuous nasogastric decompression was 43 pg/ml, suggesting that the initial hypergastrinemia was due to antral distention. It is important to consider the possibility of gastric outlet obstruction as a stimulus for serum gastrins in the range previously considered diagnostic for the Zollinger-Ellison syndrome.
Hangen
D
D
Division of Gastroenterology, Santa Clara Valley Medical Center, San Jose, CA 95128.
Maltz
G S
GS
Anderson
J E
JE
Knauer
C M
CM
D003937:Diagnosis, Differential; D005260:Female; D013271:Gastric Dilatation / Q000097:blood* / Q000150:complications; D005755:Gastrins / Q000097:blood*; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications; D011706:Pyloric Antrum; D015043:Zollinger-Ellison Syndrome / Q000175:diagnosis
D005755:Gastrins