Zollinger Ellison syndrome

Abstract

ZES is an uncommon disease with clinical manifestations akin to patients with peptic ulcer. Marked gastric acid hypersecretion can be checked but cause of death in the patients is usually metastasis. An early diagnosis and hence a possible surgical cure is very important and one must have high index of suspicion for diagnosis. As many as 50% of patients may have non diagnostic serum gastrin levels and hence need provocative tests to establish the diagnosis. Hypersecretion of acid should be controlled by antisecreting drugs followed by tumor localization with contrast CT, selective angiography and portal venous sampling for gastrin levels in doubtful cases. In MEN-I and metastatic patient, major surgery should be avoided. All pancreatic and extra pancreatic tumors should be resected if there is no metastasis.