Sporadic gastrinoma with refractory benign esophageal stricture: A case report

Abstract

BACKGROUND

Gastrinoma is characterized by an excessive release of gastrin, leading to hypersecretion of gastric acid, subsequently resulting in recurrent peptic ulcers, chronic diarrhea, and even esophageal strictures. This case report aims to improve awareness and facilitate early diagnosis and treatment of gastrinoma by presenting a rare case of gastrinoma with refractory benign esophageal stricture (RBES). Additionally, it highlights the persistent challenges that gastroenterologists encounter in managing RBES.

CASE SUMMARY

This case demonstrates a patient with gastrinoma who developed RBES and complete esophageal obstruction despite management with maximal acid suppressive therapy, multiple endoscopic bougie dilations and endoscopic incisional therapy (EIT).

CONCLUSION

It is essential to diagnose gastrinoma as early as possible, as inadequately controlled acid secretion over an extended period increases the risk of developing severe esophageal strictures. In patients with esophageal strictures causing complete luminal obstruction, blind reopening EIT presents challenges and carries a high risk of perforation.

Keywords: Gastrinoma; Zollinger-Ellison syndrome; Neuroendocrine neoplasm; Chronic diarrhea; Refractory benign esophageal stricture; Case report

Core Tip: We report a rare case of sporadic gastrinoma in a young woman who presented with chronic diarrhea, multiple peptic ulcers, and a refractory benign esophageal stricture. The case indicates that inadequately controlled acid secretion over an extended period increases the risk of developing severe esophageal strictures. It also highlights that in patients with complete esophageal strictures, blind reopening endoscopic incisional therapy presents challenges and carries a high risk of perforation.