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Updated: May 18, 2026
Establishment and Evaluation of a Risk Prediction Model for Pathological Escalation of Gastric Low-Grade Intraepithelial Neoplasia
Published on: February 16, 2024
[PPI-sensitive diarrhea - unusual case of an adolescent with sporadic gastrinoma]
S Michaelis1, C Fibbe, P Layer
1Medizinische Klinik, Israelitisches Krankenhaus, Hamburg. s.michaelis@ik-h.de
History And Clinical Findings:
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.
Investigations:
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.
Diagnosis, Treatment And Course:
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.
Conclusion:
In patients with chronic diarrhea, especially if the symptoms are PPI-sensitive, a gastrinoma should be considered.
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