Abstract
A case of Zollinger-Ellison syndrome was reported. The patient was a 46-year-old male with the chief complaint of nocturnal severe hunger pain. He had been undergone hemigastrectomy for hemorrhagic gastric ulcer five years ago.
Many clinical and laboratory examinations were made including of gastric acid secretion, X-ray check of upper G. I. series, sella trucica, endoscopic retrograde pancreaticography, selective celiac angiography, measurement of serum electrolyte, serum gastrin level and hepato-pancreatic scintigraphy.
No familial involvement was recognized in his three children at present time.
Laparotomy disclosed a giant duodenal ulcer (3×3 cm) penetrating to the liver and total gastrectomy was performed. Non-β Islet cell tumor of the pancreas and its metastasis in the liver and lymphnode could not be disclosed because of massive adhesion by the previous operation and the ulcer penetration. The serum gastrin level measured preoperatively marked maximal 1, 400 pg/ml, and gradually decreased to minimal 33.6 pg/ml three months postoperatively, but again increased to 653.2 pg/ml 22 months postoperatively.
The authors' experience was discussed with a review of the literature.
