Sporadic Duodenal Gastrinoma causing Zollinger Ellison Syndrome – A Rare Case Report

Introduction: Gastrinoma is a rare gastrin secretingneuroendocrine tumor. Clinical manifestations are nonspecificgastrointestinal (GI) symptoms or as Zollinger EllisonSyndrome(ZES) which often delays the diagnosis in majorityof patients. Hence a high clinical index of suspicion iswarranted in patients who present with nonspecific GIsymptoms to rule out gastrinoma.Case report: We report a case of 55 year old female whopresented with long standing dyspepsia and chronic diarrhoeaand was diagnosed with Sporadic Duodenal Gastrinomaon detailed evaluation. She was treated with surgicalresection and pathologically diagnosed as well differentiatedneuroendocrine tumor, Gastrinoma – grade I after IHCanalysis. Patient was relieved of her symptoms and becameeugastrinemic after surgery.Conclusion: Any patient with refractory dyspepsia associatedwith long standing non specific abdominal symptoms shouldbe evaluated for Gastrinoma and treated accordingly to avoidmisdiagnosis and complications in the long run.

Reversal of nail changes after liver transplantation in a child.

We report a 6-year-old girl who received a left-lobe live-related liver transplant for decompensated liver disease after a failed Kasai’s surgery for biliary atresia. Preoperatively, her nails were white, dystrophic, brittle with severe onycholysis, clubbing and watch-glass deformities. Nail scrapings were negative for fungus. Five months after transplantation, her nails had become near normal. There is only one such documented case in literature on reversal of nail changes in an adult.