Gastrinoma

Zollinger-Ellison syndrome (gastrinoma) is a clinical syndrome characterized by refractory/atypical peptic ulcer, high acid secretion, and a non-beta islet cell tumor. Cause is unknown; may arise from pancreatic alpha1 cells. Because tumors are often small and extrapancreatic sites are possible, localization can be difficult, but modern ultrasound/CT/MRI has improved detection. Without distant metastasis, surgical resection can be curative.

Common Symptoms

Liver metastasis; diarrhea; peptic ulcer; steatorrhea; liver failure

Causes

Gastrin's trophic effect causes gastric mucosal hyperplasia, with parietal cell mass up to 3-6x normal, leading to excess acid secretion. Gastrinomas occur throughout the abdomen, not just pancreas: pancreas 21-65%, duodenum 33-38%. Multiple endocrine neoplasia type I (MEN-I) is an autosomal dominant disorder on chromosome 11, often involving parathyroid, islets and pituitary; patients with hyperparathyroidism and MEN-I usually develop gastrinoma. Mechanism: biologically active gastrin in tumors and antrum is mainly G17, while circulating gastrin is the larger G34 form. Sulfated gastrin II predominates (59%) vs 37% in ordinary ulcers. Patients also have gastrin component 1, G17 N-terminal 1-13 fragment and C-terminal tetradecapeptide amide (mini-gastrin). Parietal cell mass is at least 3.6x normal and 2.3x that of ordinary duodenal ulcer patients; enterochromaffin cell hyperplasia and small non-invasive gastric carcinoids occur.

Treatment

Drug therapy; surgery; rehabilitation

Prevention

Stomach diseases are common and preventable. Ten rules: 1. Avoid chronic mental tension — it disrupts autonomic function and causes gastritis/ulcer. 2. Avoid overwork. 3. Avoid irregular meals. 4. Avoid excessive alcohol. 5. Avoid smoking. 6. Avoid strong tea/coffee. 7. Chew thoroughly. 8. Avoid bedtime eating. 9. Practice hygiene to prevent H. pylori. 10. Avoid overusing drugs (aspirin, phenylbutazone, indomethacin, steroids, erythromycin).

Recommended Department

It is recommended to visit the gastroenterology department; before the visit you may first book an appointment and connect with experts through this platform.

Warm reminder: The above information is provided for health education reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek care at a regular hospital in time.