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首页> 外文期刊>Hepatology research: the official journal of the Japan Society of Hepatology >Case of primary hepatic gastrinoma: Diagnostic usefulness of the selective arterial calcium injection test
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Case of primary hepatic gastrinoma: Diagnostic usefulness of the selective arterial calcium injection test

机译：例原发性肝胃泌素瘤:诊断有用性的选择性动脉钙注入测试

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摘要

Gastrinomas mainly occur in the duodenum and pancreas. Primary hepatic gastrinoma is rare and difficult to diagnose because the liver is a frequent site of metastatic gastrinomas. Clinical factors were assessed in a 28-year-old man with diarrhea and heartburn who was hospitalized for recurrent duodenal ulcers. Abdominal ultrasound, endoscopic ultrasound and computed tomography (CT) could not detect a tumor in the duodenum or pancreas. His gastrin level was 846pg/mL and magnetic resonance imaging showed a mass 12mm in diameter in the right robe of the liver. A selective intra-arterial calcium injection (SACI) test and 68-gallium edotreotide positron emission tomography CT (Ga-DOTATOC PET-CT) were therefore performed. Calcium gluconate injection into the proper hepatic artery resulted in a marked increase in serum gastrin concentration in the right hepatic vein, with Ga-DOTATOC PET-CT showing uptake only by the liver mass. Following a diagnosis of primary hepatic gastrinoma, the tumor was resected. A histopathological examination indicated gastrinoma. Six months postoperatively, he has no symptoms, is not taking proton-pump inhibitors and his gastrin level remains within the normal range. The SACI test and the clinical course of this patient strongly suggest that the tumor was a primary hepatic gastrinoma. The SACI test is helpful in the diagnosis of primary hepatic gastrinoma.
机译：主要发生在十二指肠和胃泌素瘤胰腺。很难诊断,因为肝脏是一个转移性胃泌素瘤的部位。28岁的男子因素进行评估腹泻和胃灼热住院复发性十二指肠溃疡。内窥镜超声和ct(CT)在十二指肠或无法检测肿瘤胰腺。磁共振成像显示质量12毫米直径的长袍的肝脏。选择性动脉内的钙离子注入(尚驰)测试和68 -镓edotreotide正电子发射因此,断层CT (pet - CT机Ga-DOTATOC)执行。肝固有动脉导致显著血清胃泌激素浓度的增加右肝静脉,pet - ct机Ga-DOTATOC只显示吸收由肝脏质量。原发性肝胃泌素瘤的诊断肿瘤切除。检查显示胃泌素瘤。术后,他没有症状,不是在服用ppi抑制剂和他的胃泌激素水平仍在正常范围内。测试和这个病人的临床过程强烈建议肿瘤是一个主要的肝胃泌素瘤。诊断原发性肝胃泌素瘤。

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