57 T_h e adrenal glands and other abdominal endoc

ADRENAL HAEMORRHAGE Definition Adrenal haemorrhage is a serious condition that can result in adren...

ADRENAL INSUFFICIENCY Adrenal insu ffi ciency may be primary , secondary or tertiary . Primary insu...

ANATOMY Adrenal glands The weight of a normal adrenal gland is approximately 4 /uni00A0 g. The a...

Acute adrenal insufficiency (adrenal or Addisonian crisis) This is a medical emergency . Owing to ...

Adrenocortical carcinoma Definition ACC is a rare aggressive malignancy that arises from the adren...

Appendiceal carcinoid Incidence Appendiceal NETs are the commonest neoplasm in the appendix (30–8...

Chronic adrenal insufficiency Patients with chronic adrenal insu ffi ciency may also be di ffi cult to...

Congenital adrenal hyperplasia (adrenogenital syndrome) Virilisation and adrenal insu ffi ciency in...

Conn’s syndrome (primary hyperaldosteronism) Definition First described in 1957 in a patient with ...

Cushing’s syndrome Definition Hypercortisolism may arise as a result of excess ACTH secretion (te...

DISORDERS OF THE ADRENAL MEDULLA AND DIFFUSE NEUROENDOCRINE SYSTEM Phaeochromocytoma and paragang...

Duodenum Incidence These are exceptionally rare tumours, accounting for 1–3% of all GI-NETs. Pat...

EMBRYOLOGY There are two distinct functional units in the adrenal gland: cortex and medulla. The ...

Extra-adrenal paraganglia Paraganglia are neuroendocrine cells associated with the autonomic nerv...

Ganglioneuroma Defi nition Ganglioneuromas (GNs) are benign di ff erentiated tumours of neural cre...

INCIDENTALOMA Definition An asymptomatic adrenal mass detected on imaging not performed for suspec...

INTRODUCTION Two major systems are held responsible for the regulation of homeostasis of the hum...

Learning objectives Adrenal gland To understand the investigation and diagnosis of disorders • of...

MUL TIPLE ENDOCRINE NEOPLASIA MEN is a group of heterogeneous disorders characterised by a predi...

Metastases Definition Adrenal metastases are not uncommon and often portend - disseminated incurab...

Minimally invasive adrenalectomy Transperitoneal laparoscopic adrenalectomy Familiarity with the ...

Multiple endocrine neoplasia type 1 Epidemiology and genetics MEN /uni00A0 1 is an autosomal domi...

Multiple endocrine neoplasia type 2A . ). In Epidemiology and genetics MEN /uni00A0 2A has a prev...

Multiple endocrine neoplasia type 2B Epidemiology and genetics - This has a prevalence of 0.2 in...

Multiple endocrine neoplasia type 4 Described in 2006, this is an exceptionally rare autosomal do...

Neuroblastoma Definition Neuroblastoma (NB) is the most common and deadliest solid extracranial ma...

Non-functioning pancreatic neuroendocrine tumours Definition P-NETs are clinically classified as no...

OF THE STOMACH AND SMALL INTESTINE Embryology and physiology The embryology of the intestine is ...

PANCREATIC NEUROENDOCRINE TUMOURS Introduction As with neuroendocrine cells in the intestine, pan...

PHYSIOLOGY The outer zona glomerulosa secretes the C21 steroid aldosterone. The zona fasciculata ...

Pathogenesis Historically , tumours arising from the neuroendocrine cells were referred to as ‘ka...

Physiology of the endocrine pancreas The endocrine cells of the pancreas are grouped in the isle...

SURGERY OF THE ADRENAL GLANDS Since its description in the 1990s by Gagner, laparoscopic adre - n...

Small intestine Incidence Midgut carcinoids are the most common NETs with a peak age of diagnosi...

Stomach Incidence These are rare with an incidence of 0.2 per 100 /uni00A0 000 population per ye...

Treatment Medical Metyrapone or ketoconazole therapy reduces steroid synthesis and secretion by C...