CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2018; 09(02): 085-087
DOI: 10.4103/jde.JDE_27_17
Case Report
Society of Gastrointestinal Endoscopy of India

A Man with Diarrhea

Kayalvizhi Rajini
Department of Digestive Health and Disease, Kilpauk Medical College, Chennai, Tamil Nadu, India
,
T. Rajkumar Solomon
Department of Digestive Health and Disease, Kilpauk Medical College, Chennai, Tamil Nadu, India
,
Aravind Arumugham
Department of Digestive Health and Disease, Kilpauk Medical College, Chennai, Tamil Nadu, India
,
Balamurali Rangachari
Department of Digestive Health and Disease, Kilpauk Medical College, Chennai, Tamil Nadu, India
› Author Affiliations
Further Information

Publication History

Publication Date:
24 September 2019 (online)

  

ABSTRACT

Diarrhea, a common presenting complaint which we come across in our day‑to‑day practice, is often self‑limited but can be challenging at times. Here, we report one such patient. A 54‑year‑old male presented with diarrhea, abdominal pain, anorexia, and weight loss. Routine blood and stool examination was not helpful. A colonoscopy done elsewhere showed a fistulous opening in the anal canal for which he underwent a fistulectomy. Esophagogastroduodenoscopy revealed severe esophagitis, multiple duodenal ulcers, and a fundic gland polyp from which biopsies were taken. The fundic gland polyp showed oxyntic gland hyperplasia. Basal acid output and serum fasting gastrin subsequently measured were also high. A diagnosis of Zollinger–Ellison syndrome was made, and the patient was started on high‑dose proton‑pump inhibitors, to which he had excellent response. Repeat endoscopy showed resolutions of all lesions. Endoscopic ultrasound (EUS) and DOTA (Gallium (68Ga) DOTA-TATE) scan revealed a tumor in the duodenum and pylorus, respectively. On surgical exploration, the tumor was identified in the second part of the duodenum and was removed. The patient has remained asymptomatic since then.