Document Detail


Localization of gastrinomas by selective intra-arterial calcium injection in patients on proton pump inhibitor or H2 receptor antagonist therapy.
MedLine Citation:
PMID:  15756095     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Preoperative localization is important for the successful treatment of gastrinomas. The aim of this study was to investigate whether selective intra-arterial calcium injection and hepatic venous sampling was able to localize gastrinomas in four patients who remained on proton pump inhibitor or H2 antagonist therapy. Calcium gluconate was injected directly into the arteries supplying the pancreas and liver after standard selective angiography. Gastrin levels were then measured in samples taken from the right hepatic vein. Calcium gluconate produced a diagnostic rise (at least 2-fold) in serum gastrin and unequivocally localized the tumour to a specific vascular territory in each case. One patient did not undergo surgery. In the remaining three patients, surgery confirmed the position and histology of the tumour. This study shows that in four patients with a confirmed gastrinoma we were able to localize the gastrinoma by selective intra-arterial calcium injection and hepatic venous sampling, whilst the patients remained on proton pump inhibitor or H2 antagonist therapy, thereby reducing their risk of gastrointestinal perforation.
Authors:
Waljit S Dhillo; Channa N L Jayasena; James E Jackson; John A Lynn; Stephen R Bloom; Karim Meeran; Jeannie F Todd
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  17     ISSN:  0954-691X     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-03-09     Completed Date:  2005-05-31     Revised Date:  2009-10-16    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  429-33     Citation Subset:  IM    
Affiliation:
Department of Endocrinology, Imperial College Faculty of Medicine, Hammersmith Hospital, London W12 0NN, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Specimen Collection
Calcium Gluconate / diagnostic use*
Female
Gastrinoma / diagnosis*,  drug therapy
Hepatic Veins
Histamine H2 Antagonists / therapeutic use*
Humans
Injections, Intra-Arterial
Intestinal Perforation / prevention & control
Liver / blood supply
Male
Middle Aged
Omeprazole / therapeutic use
Pancreas / blood supply
Pancreatic Neoplasms / diagnosis*,  drug therapy
Proton Pumps / antagonists & inhibitors*
Ranitidine / therapeutic use
Stimulation, Chemical
Chemical
Reg. No./Substance:
0/Histamine H2 Antagonists; 0/Proton Pumps; 299-28-5/Calcium Gluconate; 66357-35-5/Ranitidine; 73590-58-6/Omeprazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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