Zollinger–Ellison Syndrome

Background

Zollinger–Ellison (ZE) syndrome is characterized by gastric acid hypersecretion and ulcer disease from autologous gastrin secretion by a gastrinoma.

Patient and methods

A 43 year old man underwent upper endoscopy for a 6 week history of recurrent nausea, vomiting, heartburn, weight loss, and watery diarrhea.

Results

Endoscopic findings included severe reflux esophagitis with multiple linear esophageal ulcerations, thickened gastric folds with mosaic pattern mucosa, distinctive gastric corpus and antrum junction, numerous antral erosions with traces of coffee ground substance, bulbar erosions and ulcerations, and post-bulbar erosions and ulcerations. Based on these symptoms and endoscopic findings, a gastrinoma work-up was instituted and the diagnosis was confirmed.

Conclusions

Endoscopists need to be aware of the classical symptoms and clinical findings associated with ZE syndrome in order to appropriately diagnose and manage affected patients.