Synchronous involvement of the esophagus, stomach, and small intestine by peptic ulceration has not been previously described in the Zollinger-Ellison syndrome. Two patients presented with abdominal pain, diarrhea, weight loss, and dysphagia while on acid suppressants. Fasting hypergastrinemia was confirmed. Endoscopy revealed peptic stricture of the esophagus with ulcerations in the stomach, duodenum, and jejunum. Imaging showed a mass in the head of pancreas. The first patient underwent distal esophagectomy, total gastrectomy, and resection of the head of pancreas for a pancreatic primary. Resection of the third and fourth parts of the duodenum and proximal jejunum was undertaken in the second patient with a duodenal primary. Malignant gastrinoma was confirmed histologically. "Supergastrinoma" describes a tumor causing synchronous peptic ulceration and/or stricture extending from the esophagus to the jejunum. Operative management entails customized resection of the areas irretrievably damaged by the ulceration together with the tumor.

译文

:Zollinger-Ellison综合征以前没有描述消化性溃疡引起食管,胃和小肠的同时受累。两名患者在使用抑酸剂时出现腹痛,腹泻,体重减轻和吞咽困难。确认禁食高胃泌素血症。内窥镜检查显示食管的消化道狭窄,胃,十二指肠和空肠有溃疡。影像学检查显示胰头有肿块。首例患者接受了远端食管切除术,全胃切除术以及胰腺原发性胰腺切除。在第二例十二指肠原发患者中切除十二指肠的第三和第四部分以及空肠近端。在组织学上证实为恶性胃泌素瘤。 “上胃泌素瘤”描述了引起从食道到空肠的同步消化性溃疡和/或狭窄的肿瘤。手术管理需要对因溃疡和肿瘤而无法修复的区域进行定制切除。

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