A 45-year-old woman develops upper gastrointestinal hemorrhage. Evaluation by upper endoscopy reveals three ulcers in the second portion of the duodenum. Bleeding is controlled using an endoscopic heat probe. Further investigation reveals a serum gastrin value of 240 pg/mL. Which of the following would support the presumptive diagnosis of gastrinoma?
A. An increase of 320 pg/mL in serum gastrin upon intravenous infusion of secretin
B. Gastric acid analysis demonstrating fasting acid secretion of 3 mEq/h
C. Enlarged gastric rugae on upper gastrointestinal contrast study
D. An increase of 150 pg/mL in serum gastrin upon intravenous infusion of cholecystokinin
Answer:A
A 45-year-old woman develops upper gastrointestinal hemorrhage. Evaluation by upper endoscopy reveals three ulcers in the second portion of the duodenum. Bleeding is controlled using an endoscopic heat probe. Further investigation reveals a serum gastrin value of 240 pg/mL. Which of the following would support the presumptive diagnosis of gastrinoma?
A. An increase of 320 pg/mL in serum gastrin upon intravenous infusion of secretin B. Gastric acid analysis demonstrating fasting acid secretion of 3 mEq/h C. Enlarged gastric rugae on upper gastrointestinal contrast study D. An increase of 150 pg/mL in serum gastrin upon intravenous infusion of cholecystokinin