Zollinger-Ellison syndrome

Zollinger-Ellison syndrome defines severe peptic ulcer disease secondary to unregulated gastrin release from a non-beta cell endocrine tumour. It is one type of disease of the gastrointestinal system. The aetiology is 1. Most common site of gastrinoma is in pancreas, 2.Gastrinoma can occur in non-pancreatic sites, 3.More than 60% of these tumours are malignant, 4. Gastrinoma may be a part of multiple endocrine neoplasia. Some clinical features are manifestations of peptic ulcerations but of shorter duration, ulcers are severe can occur at unusual sites like jejunum or oesophagus, bleeding and perforation are common, may present as intractable recurrent ulceration, following surgery for peptic ulcer, diarrhea occurs in nearly 50% cases and about one-third of patients have multiple endocrine neoplasia. Following investigation should be followed for this disease 1. Barium meal shows abnormally coarse gastric folds and ulcers; 2.Endoscopy reveals multiple ulcers at atypical sites; 3.Gastrin level in the blood is raised; 4.Tumour localization by ultrasound, endoscopic ultrasound and CT abdomen; 5.Another method of tumour localization is a radionuclide scan using oestroscan. Some treatments are surgical removal of the tumour whenever possible, Omeprazole can heal the ulcers but in the higher dose and unresponsive patients are treated by total gatrectomy.