선택적 동맥내 칼슘주입법으로 진단된 Zollinger-Ellison 증후군 1예
A case of Zollinger-Ellison syndrome: localization of gastrinoma by selective intra-arterial calcium injection
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초록
저자들은 내원 일주일 전부터 시작된 상복부 동통과 속쓰림을 주소로 내원한 60세 남자에서 상부위장관 내시경 시행 결과 역류성 식도염과 십이지장 구부 이후의 다발성 궤양을 보이고 공복 혈청 가스트린치가 1,470 pg/mL 이상으로 현저히 상승되어 산발성 Zollinger- Ellison 증후군으로 진단하였고, 복부 전산화단층촬영과 선택적 동맥내 칼슘 주입법으로 종양의 위치 파악에 성공한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Zollinger-Ellison syndrome is a very rare disease that's caused by tumor having gastrin-producing cells, and this is accompanied by hypergastrinemia leading to gastric acid hypersecretion, peptic ulcer and their complications. A 60-year-old man presented with epigastric pain and soreness he had experienced for 7 days. The endoscopic findings showed reflux esophagitis and multiple active ulcers at the antrum, the duodenal bulb and the 2nd and 3rd portions of the duodenum. The fasting serum gastrin level was markedly elevated above 1,470 pg/mL and this was consistent with the findings of gastrinoma. We confirmed the presence of gastrinoma via the abdomen CT scan and selective intra-arterial calcium injection. This is the first Korean case report of gastrinoma that was localized by selective intra-arterial calcium injection.(Korean J Med 72:529-535, 2007)
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