Definition:
Disorder in which severe peptic ulceration is found due to edema or hyperplasia of islet of pancrease which secrete gastrin resulting in hyperchlorhydria.
Pathology:
Tumor my be benign 40 % and malignant in 60 % cases. it may be located in stomach , duodenum ,spleen or even lymph nodes, multiple endocrine neoplasia i.e. pancreatic , pituitary and parathyroid tumor co-exist with it.
Clinical features:
- Severe epigastric pain due to ulcer
- Diarrhea, steatorhea
- Bleeding
- Perforation
- Family history
- Multiple endocrine neoplasia features
Investigations
- Serum gastrin level
- Serum calcium level
- Barium sows 75% ulcer in duodenal bulb in distal duodenum or in jejujum.
Treatment:
- H2 receptor blocker drugs
- Anticolinergic drug
- Omeprazole
- Total gastrectomy