title: [PPI-sensitive diarrhea - unusual case of an adolescent with sporadic gastrinoma].
abstract: METHODS
  A 14-year-old boy was admitted to hospital because of chronic episodic diarrhea lasting for 4 years. Previous investigations in the past had not revealed the cause of the symptoms.
  
  
  METHODS
  The 13C-triglyceride breathing test showed a diminished intestinal lipolysis. Endoscopic examination demonstrated small gastroduodenic ulcers. During therapy with proton-pump inhibitors the diarrhea stopped.
  
  
  METHODS
  The combination of gastroduodenic ulcers and improvement of diarrhea with PPI-therapy were suggestive of Zollinger-Ellison syndrome. Endosonography and MR-scan showed an extrapancreatic mass with marked activity during somatostatin receptor scintigraphy. The primary tumor was excised, a liver metastasis was treated with radiofrequency ablation. The histological examination confirmed the diagnosis of a gastrinoma.
  
  
  CONCLUSIONS
  In patients with chronic diarrhea, especially if the symptoms are PPI-sensitive, a gastrinoma should be considered.
authors.affiliation: Medizinische Klinik, Israelitisches Krankenhaus, Hamburg. s.michaelis@ik-h.de
authors.forename: S
authors.initials: S
authors.lastname: Michaelis
authors.forename: C
authors.initials: C
authors.lastname: Fibbe
authors.forename: P
authors.initials: P
authors.lastname: Layer
mesh_terms: D000293:Adolescent; D017115:Catheter Ablation; D002908:Chronic Disease; D003952:Diagnostic Imaging; D003967:Diarrhea / Q000188:drug therapy* / Q000209:etiology; D019160:Endosonography; D004942:Esophagitis, Peptic / Q000175:diagnosis / Q000188:drug therapy; D015408:Gastrinoma / Q000150:complications* / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D005773:Gastroscopy; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D008297:Male; D009852:Omentum / Q000473:pathology / Q000601:surgery; D010437:Peptic Ulcer / Q000175:diagnosis / Q000188:drug therapy; D010534:Peritoneal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D015043:Zollinger-Ellison Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery
chemical_list: D054328:Proton Pump Inhibitors