Zollinger-Ellison syndrome

Zollinger-Ellison syndrome yog ib yam mob uas lub cev ua tawm ntau dhau ntawm lub zog gastrin. Yuav luag txhua lub sijhawm, lub qog ntshav (gastrinoma) nyob rau hauv lub caj pas lossis plab hnyuv plab yog qhov ua kom muaj qhov plab hnyuv ntxiv nyob rau hauv cov ntshav.

Zollinger-Ellison syndrome tshwm sim los ntawm cov qog ntshav. Cov kev loj hlob no feem ntau pom muaj nyob rau hauv lub taub hau ntawm cov txiav thiab cov hnyuv hnyuv. Cov qog hlav no hu ua gastrinomas. Theem ntau ntawm gastrin ua rau kev tsim cov kua qaub ntau dhau.

Gastrinomas tshwm sim li ib leeg hlav lossis ob peb lub qog. Ib nrab rau ob feem peb ntawm ib leeg gastrinomas yog mob qog nqaij hlav (malignant). Cov hlav no feem ntau kis rau lub siab thiab cov qog nyob ze.

Ntau tus neeg uas muaj tus kab mob gastrinomas muaj ntau lub qog ua ib feem ntawm qhov mob hu ua endocrine neoplasia hom I (MEN I). Cov hlav tej zaum yuav hlav ua lub qog pituitary caj pas (hlwb) thiab parathyroid caj pas (caj dab) zoo li hauv cov txiav ua kab mob thiab

Cov tsos mob tuaj yeem suav nrog:

• Mob plab
• Zawv plab
• Ntuav ntshav (qee zaum)
• Kev mob ntsws es mob leeg nqog ntshav (GERD)

Cov paib muaj xws li mob hauv plab thiab plab hnyuv me.

Kev Xeem muaj xws li:

• Mob plab hauv TV
• Tshuaj calcium infusion test
• Endoscopic ultrasound
• Tshawb nrhiav phais
• Gastrin ntshav tiaj
• Octreotide luam theej duab
• Kev kuaj kev zais cia zais cia

Cov tshuaj hu ua proton twj tso kua mis inhibitors (omeprazole, lansoprazole, thiab lwm yam) tau siv los kho qhov teeb meem no. Cov tshuaj no txo ​​cov kua qaub tsim tawm los ntawm lub plab. Qhov no pab lub qhov txhab ua rau hauv plab thiab plab hnyuv kho kom zoo. Cov tshuaj no tseem pab txo qhov mob plab thiab raws plab.

Kev phais txhawm rau tshem tawm ib qho gastrinoma tuaj yeem ua yog tias cov qog hlav tsis tau kis mus rau lwm yam kabmob. Kev phais mob hauv lub plab (gastrectomy) los tswj cov kua qaub yog tsis xav tau.

Qhov kev kho mob tsawg kawg nkaus, txawm tias thaum ntxov pom thiab cov qog tshem tawm. Txawm li cas los xij, gastrinomas loj hlob qeeb.Cov neeg muaj tus mob no yuav nyob tau ntau xyoo tom qab pom cov qog. Cov tshuaj tua kab mob ua haujlwm zoo rau kev tswj cov tsos mob.

Teeb meem yuav suav nrog:

• Tsis nrhiav lub qog thaum phais
• Mob hnyuv los yog qhov tawm (perforation) los ntawm cov mob rau hauv lub plab lossis duodenum
• Kev mob nyhav thiab yuag
• Tshaj tawm ntawm cov qog mus rau lwm yam kabmob

Hu rau koj tus kws kho mob yog tias koj mob plab heev uas tsis ploj, tshwj xeeb yog tias nws mob raws plab.

Tus mob Z-E mob; Lub plab

• Cov qog endocrine

Jensen RT, Norton JA, Oberg K. Neuroendocrine hlav. Hauv: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger thiab Fordtran's Gastrointestinal thiab Kab Mob SiabCov. 10 tus ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 33.

Vella A. Lub plab thiab lub plab cov qog endocrine hlav. Hauv: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Phau Ntawv ntawm EndocrinologyCov. 13th ed. Philadelphia, PA: Elsevier; 2016: chap 38.