Neoplasms of the Endocrine Pancreas Differential Diagnoses

Updated: Feb 01, 2018
  • Author: Evan S Ong, MD, MS; Chief Editor: Neetu Radhakrishnan, MD  more...
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DDx

Diagnostic Considerations

The differential diagnosis (DDX) of hypoglycemia includes reactive hypoglycemia, functional hypoglycemia associated with gastrectomy or gastroenterostomy, nonpancreatic tumors, pleural mesothelioma, sarcoma, adrenal carcinoma, hepatocellular carcinoma, carcinoid, hypopituitarism, chronic adrenal insufficiency, extensive hepatic insufficiency, and surreptitious self-administration of insulin or ingestion of oral hypoglycemic agents. [12] See the review article by Service for an exhaustive list. [31]

The DDX of peptic ulcer includes Helicobacter pylori infection, NSAID use, gastric cancer, duodenal cancer, pancreatic cancer, ischemic gastric injury, and postoperative marginal ulcer.

The DDX of hypergastrinemia due to nonulcerogenic causes (ie, with normal-to-low acid secretion) includes atrophic gastritis, pernicious anemia, previous vagotomy, renal failure, and short-gut syndrome. [12]

The DDX of hypergastrinemia due to ulcerogenic causes (ie, with excessive acid secretion) includes antral G cell hyperplasia or hyperfunction, gastric outlet obstruction, retained excluded antrum, and Zollinger-Ellison syndrome. [12]

The DDX of watery diarrhea includes villous adenoma, laxative abuse, celiac disease, parasitic and infectious diseases, inflammatory bowel disease, carcinoid syndrome, and gastrinoma. [12]

Differential Diagnoses