Gastrointestinal Manifestations of Primary Hyperaparathyroidims (PHPT)

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • PHPT has been associated with peptic ulcer disease:
    • In experimental animals:
      • Hypergastrinemia has been shown to result from PTH infusion into blood vessels supplying the stomach, independent of its effects on serum calcium:
        • The fact is that 12% of patients with primary hyperparathyroidism have peptic ulcer-related symptoms
  • An increased incidence of pancreatitis also has been reported in patients with PHPT:
    • Although this appears to occur only in patients with profound hypercalcemia:
      • Ca2+ ⩾12.5 mg/dL
    • Prevalence:
      • 3.6% (range: 1.5% to 15.3%) 
    • Mechanism:
      • Calcium deposition in the pancreatic ducts
      • Calcium activation of trypsinogen
  • Patients with PHPT also have an increased incidence of cholelithiasis:
    • Presumably due to:
      • PTH inhibition of:
        • Gallbladder emptying
        • Hepatic bile secretion
        • Sphincter Oddi motility
        • As well as modification of bile composition:
          • An increase in biliary calcium:
            • Which leads to the formation of calcium bilirubinate stones
    • The incidence has been reported as high as 25%

#Arrangoiz #ParathyroidSurgeon #ParathyroidExpert #HeadandNeckSurgeon #EndocrineSurgery #Hyperparathyroidism #Hypercalcemia #CASO #CenterforAdvancedSurgicalOncology

Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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