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Marked hypergastrinemia in gastric outlet obstruction
D Hangen1, G S Maltz, J E Anderson
1Division of Gastroenterology, Santa Clara Valley Medical Center, San Jose, CA 95128.
Journal of Clinical Gastroenterology
|August 1, 1989
Summary
Elevated gastrin levels may not always indicate Zollinger-Ellison syndrome. Gastric outlet obstruction can cause falsely high gastrin, mimicking this condition.
Area of Science:
- Gastroenterology
- Endocrinology
- Internal Medicine
Background:
- Zollinger-Ellison syndrome is characterized by elevated gastrin levels, often due to a gastrinoma.
- Gastric outlet obstruction can lead to gastric hypersecretion and distention.
Observation:
- A patient with peptic ulcer disease and bowel obstruction presented with gastric outlet obstruction.
- Initial serum gastrin was 1,251 pg/ml, suggesting Zollinger-Ellison syndrome.
- No gastrinoma was found during subsequent evaluation.
Findings:
- A repeat serum gastrin level after nasogastric decompression was 43 pg/ml.
- This indicates the initial hypergastrinemia was likely due to gastric distention from outlet obstruction.
- Gastric outlet obstruction can mimic Zollinger-Ellison syndrome.
Implications:
- Clinicians should consider gastric outlet obstruction in patients with elevated serum gastrin.
- This finding can prevent misdiagnosis of Zollinger-Ellison syndrome.
- Accurate diagnosis requires considering mechanical factors affecting gastric physiology.