A 32-year-old man presents to the clinic with a 3-month history of epigastric pain and chronic diarrhea, along with an 8-pound weight loss. He denies NSAID use, alcohol abuse, or smoking. He has had multiple episodes of duodenal ulcer disease confirmed on previous upper endoscopies despite appropriate acid-suppressive therapy. Vital signs are stable. Laboratory studies show a fasting serum gastrin level of 580 pg/mL (normal <100 pg/mL) and an elevated 24-hour gastric acid output. Repeat upper endoscopy demonstrates multiple duodenal ulcers with severe gastric rugae. Which of the following is the most likely diagnosis?
- A)H. pylori-associated peptic ulcer disease
- B)NSAID-induced peptic ulcer disease
- C)Zollinger-Ellison syndromeGABARITO
- D)Primary hyperparathyroidism with peptic ulcer
- E)Gastric adenocarcinoma with gastrin-secreting differentiation
Explicação
Zollinger-Ellison syndrome (ZES) is a gastrin-secreting neuroendocrine tumor that causes severe peptic ulcer disease through gastric acid hypersecretion. The diagnostic triad includes: (1) severe/recurrent peptic ulcers despite adequate therapy, (2) elevated f... Ver explicação completa e trilha adaptativa →