Secretin and calcium provocative tests in the Zollinger-Ellison syndrome: a prospective study
Article Abstract:
Zollinger-Ellison syndrome is characterized by excessive secretion of gastric acid, peptic ulcers, and pancreatic tumors. Timely and accurate diagnosis of this condition is important because the tumor, a common complication of the disease, frequently becomes malignant. It is sometimes difficult to distinguish these patients from individuals with other conditions that have similar symptoms. The diagnostic effectiveness of two different provocative tests (tests that stimulate a particular response) for Zollinger-Ellison syndrome was examined in a study of 80 patients with this condition. The secretin test was administered intravenously; serum (blood fraction) gastrin concentrations were measured before and after secretin infusion. For the calcium infusion test, serum calcium and gastrin concentrations were measured before infusion and at various intervals during infusion. Both tests were performed while patients were fasting. The secretin test was the preferred diagnostic tool. It had greater sensitivity and was easier to perform than the calcium test. False-positive and false-negative results were noted when the calcium test was performed, and seven percent of the subjects experienced side effects from this procedure. The calcium test is recommended for patients who have excessive gastric acid secretion but negative results from the secretin test while Zollinger-Ellison syndrome is still suspected. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1989
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Localization in insulinomas to regions of the pancreas by intra-arterial stimulation with calcium
Article Abstract:
The location of small insulinomas may be most accurately identified by selectively stimulating the release of insulin with calcium injections into the arteries supplying the pancreas. Insulinomas are insulin releasing tumors of the pancreas. Elevated levels of insulin produced in a particular artery may indicate the presence of an insulinoma in the segment of the pancreas that the selected artery supplies. Researchers compared arterial calcium stimulation with other imaging techniques in identifying the location of insulinomas in 25 patients with surgically confirmed insulinomas. Arterial calcium stimulation accurately predicted the location of the insulinomas in 88% of the cases. The other imaging techniques were less accurate. Portal venous sampling was 67% accurate, magnetic resonance imaging was 43% accurate, arteriography was 36% accurate.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1995
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