Diagnosis of Zollinger–Ellison syndrome in Hospital Neuperlach Munich

About the department

The Department of Gastroenterology and Hepatology at the Hospital Neuperlach Munich offers the full range of modern diagnostic and therapeutic methods for diseases of the gastrointestinal tract, pancreas, bile ducts, gallbladder and liver. One of the most important focuses of the department's work is colon cancer treatment. It is provided within the specialized Colon Cancer Center certified in accordance with the requirements of the German Cancer Society. In addition, the department has special competence in the treatment of chronic inflammatory bowel disease – Crohn's disease and ulcerative colitis. The patients' health is in the safe hands of the highly professional medical team consisting of 16 doctors and 34 nurses. The department's specialists cooperate closely with doctors from the Department of General and Abdominal Surgery, as well as with external partner hospitals. More than 3,500 patients undergo treatment in the department every year, which indicates a high level of patient's satisfaction with the quality of medical care. The department is headed by Dr. med. Markus Dollhopf.

The treatment of colon polyps and colon cancer is an integral part of work of the department's gastroenterologists. The medical facility has advanced endoscopic equipment, with the help of which the doctors can accurately examine the colon and, if necessary, perform sparing interventional treatment. Colonoscopy is usually sufficient to detect colon polyps. In addition, the department successfully uses such diagnostic methods as narrow band imaging and chromoendoscopy, which allow obtaining comprehensive information about the degree of polyp growth into the bowel wall, determining their clear boundaries, etc. Should pathology be detected, the doctor can immediately remove the polyps using endoscopic techniques. As of today, the department's excellent medical and technical base enables the doctors to perform endoscopic removal of large polyps, which previously required an open surgical procedure. After resection of intestinal polyps, the doctor sends a sample of the removed tissue for microscopic examination to exclude colon cancer. Thus, timely detection and removal of polyps prevents the development of the oncological process, as well as massive bleeding, which are a common complication of this pathology. If the follow-up microscopic diagnostics confirms colon cancer, the patient will have to undergo additional imaging tests in order to determine the exact type of tumor, its stage, localization, presence or absence of metastases, etc. With all the diagnostic data, gastroenterologists jointly with the specialists from related medical fields prescribe the required therapeutic measures. At the initial stages of the oncological process, the doctors can often perform endoscopic resection of the tumor. If the cancer spreads metastases, then the patient requires surgery, which is performed in cooperation with abdominal surgeons. The surgical procedure can be complemented by chemotherapy or radiation therapy, the type and duration of which are determined for each patient individually.

An equally important focus of ​​work of the department's medical team is esophageal cancer treatment. Unfortunately, in most cases, esophageal cancer is detected at the advanced stages, since the patient does not experience any symptoms for a long time, which could become a reason for visiting a doctor. When the first symptoms manifest themselves, the tumor is usually at the advanced stages, which greatly complicates treatment and reduces the chances for a complete recovery. Barrett's esophagus is often the precursor to esophageal cancer. If during endoscopic diagnostics, the department's gastroenterologists detect a pathology, the patient receives the required treatment. The department's therapeutic options include endoscopic mucosal resection, endoscopic submucosal dissection, hybrid argon plasma coagulation and radiofrequency ablation. However, if doctors suspect esophageal cancer, endoscopic examinations will be complemented by advanced imaging diagnostics (X-ray, CT, PET-CT). The treatment regimen for each patient is developed at an interdisciplinary tumor board with the participation of gastroenterologists, abdominal surgeons, radiologists, chemotherapists and other experts. The treatment of esophageal cancer is based on the surgical resection of the tumor, which is often complemented by chemoradiation therapy. The department's medical team has vast experience in the treatment of esophageal cancer, so the patients can count on highly qualified medical care.

The department's gastroenterologists often admit patients with suspected chronic inflammatory bowel disease (Crohn's disease and ulcerative colitis). To confirm the diagnosis, the specialists carry out comprehensive diagnostics, which includes laboratory tests, ultrasound examinations, colonoscopy, magnetic resonance imaging and other tests. The first line treatment for chronic inflammatory bowel disease is drug therapy and diet therapy. In some cases, even at the stage of endoscopic diagnostics (colonoscopy), the specialist can perform therapeutic procedures to dilate stenotic sections of the intestine, stop gastrointestinal bleeding or remove polyps. If medical treatment does not give good results, the doctors will have to resort to surgery. The surgical treatment for Crohn's disease and ulcerative colitis is provided in cooperation with abdominal surgeons. As a rule, the operation is performed using sparing minimally invasive techniques.

The department specializes in the diagnostics and treatment of the following diseases:

• Malignant diseases
  • Colon cancer
  • Stomach cancer
  • Esophageal cancer
  • Pancreatic cancer
  • Gallbladder cancer
  • Bile duct cancer
  • Neuroendocrine tumors
• Benign diseases
  • Colorectal polyps
  • Stomach polyps
  • Barrett's esophagus
  • Chronic inflammatory bowel disease (Crohn's disease and ulcerative colitis)
  • Gallstone disease
  • Cholestasis
  • Jaundice
  • Pancreatitis
• Other pathologies

The department's range of medical services includes:

• Diagnostics and treatment of diseases of the esophagus, stomach and colon
  • Diagnostic tests
    • High-resolution videoendoscopy
    • Endosonography
    • High-resolution sonography, including Doppler and color Doppler, as well as liver elastography
    • Contrast-enhanced ultrasonography and contrast‑enhanced harmonic endoscopic ultrasound
    • Capsule enteroscopy
    • Diagnostic double-balloon enteroscopy
    • High-resolution esophageal manometry
    • 24-hour esophageal manometry
    • Hydrogen breath test
  • Therapeutic procedures
    • Therapeutic double-balloon enteroscopy
    • Endoscopic polypectomy
    • Endoscopic mucosal resection
    • Cap-assisted endoscopic mucosal resection
    • Endoscopic submucosal dissection
    • Radiofrequency ablation of the esophagus (HALO technology)
    • Argon plasma coagulation
    • Percutaneous endoscopic gastrostomy
• Diagnostics and treatment of diseases of the pancreas, biliary tract and liver
  • Diagnostic tests
    • Cholangioscopy and pancreatoscopy
    • Diagnostic endosonography
    • Sonography, including color Doppler and duplex sonography, as well as contrast-enhanced sonography and liver elastography
  • Therapeutic procedures
    • Endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiodrainage and lithotripsy with electrohydraulic shock wave generation for the treatment of gallstones and pancreatic stones
    • Therapeutic endosonography
    • Ultrasound-guided puncture and drainage of abscesses
    • Radiofrequency ablation of the bile ducts, including for inoperable bile duct tumors
    • Transduodenal papillectomy
• Palliative endoscopic procedures
  • Stent implantation in case of stenosis caused by gastrointestinal cancers (esophageal, stomach, small and large bowel cancers), as well due to benign neoplasms (rare)
  • Endosonographic-guided gastroenterostomy for the formation of bypasses for the movement of food masses in the case of stenoses caused by malignant and benign tumors
  • Internal biliary drainage in case of malignant tumors with a biliodigestive anastomosis on the duodenum, stomach or jejunum
  • Percutaneous endoscopic gastrostomy
  • Placement of percutaneous bile drains
  • Placement of percutaneous drains for malignant ascites or pleural effusion
• Other medical services