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Behandlungsstrategie bei Zollinger-Ellison-Syndrom

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Der Magen

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Zusammenfassung

Der schwierigste Schritt bei der Erstellung der Diagnose „Zollinger-Ellison-Syndrom“ (ZES) ist, diese Möglichkeit überhaupt zu bedenken. Das typische Auftreten kann nicht mehr länger als das eines schweren peptischen Ulkus an untypischer Stelle angesehen werden, wie ursprünglich beschrieben worden ist [12]. Die Patienten haben häufig typische peptische Ulzera, oder sie können an persistierender, rezidivierender oder komplikationsreicher peptischer Ulkuskrankheit, schwerer Ösophagitis, wässrigen Diarrhoen oder Malabsorptionssyndromen mit oder ohne peptischer Ulkuskrankheit leiden [27, 70]. Einige Patienten haben Nierensteine und ein Ulkusleiden oder andere Beschwerden in der Familienanamnese [11]. Die Diagnose eines Zollinger-Ellison-Syndroms sollte bei jedem Patienten in Erwägung gezogen werden, der sich einer Magenoperation unterzieht. Die beste Screening-Methode für ein ZES ist die Bestimmung des Nüchterngastrinspiegels im Serum (normal > 100 pg/ml). Für die anfängliche Suche kann der Patient seine antisekretorische Medikation beibehalten. Bei Gastrinwerten im Bereich von 110–500 pg/ml unter H2-Antagonisten—Therapie oder im Bereich von 110–3000 pg/ml unter Therapie mit Orneprazol sollte die Gastrin-Bestimmung jedoch 24 Stunden nach Absetzen von H2-Antagonisten bzw. 6 Tage nach Absetzen von Omeprazol wiederholt werden [70].

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  1. P. N. Maton
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Editors and Affiliations

  1. Medizinischen Klinik und Poliklinik B, Universität Münster, Albert-Schweitzer-Straße 33, D-48149, Münster, Deutschland

    W. Domschke FACG (Direktor) (Direktor)

  2. Instituts für Physiologie, Universität Kraków, Grzegórzecka 16, PL-31531, Kraków, Polen

    S. J. Konturek (Direktor) (Direktor)

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Maton, P.N. (1993). Behandlungsstrategie bei Zollinger-Ellison-Syndrom. In: Domschke, W., Konturek, S.J. (eds) Der Magen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-06526-6_18

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  • DOI: https://doi.org/10.1007/978-3-662-06526-6_18

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