Clinical Gastroenterology Vol.28 No.1(8)

Theme Gastroenteropancreatic Neuroendocrine Tumors
Title Gastrinoma
Publish Date 2013/01
Author Ryuichiro Doi Department of Surgery, Otsu Red Cross Hospital
Author Yoshinori Kito Department of Surgery, Otsu Red Cross Hospital
Author Koichi Hanamoto Department of Surgery, Otsu Red Cross Hospital
Author Katsuaki Ura Department of Surgery, Otsu Red Cross Hospital
Author Kaoru Taira Department of Surgery, Otsu Red Cross Hospital
Author Hideaki Oe Department of Surgery, Otsu Red Cross Hospital
Author Akira Yoshikawa Department of Surgery, Otsu Red Cross Hospital
Author Shun-ichi Ishigami Department of Surgery, Otsu Red Cross Hospital
[ Summary ] Gastrinoma is a type of neuroendocrine tumor found in the pancreas or duodenum which secretes excess gastrin, leading to ulceration of the duodenum, stomach and sometimes of the esophagus or small intestine. Hypersecretion of stomach acid causes hyperacidity and ulcers. This acid also causes hyperperistalsis and inhibits the activity of lipase, causing severe diarrhea. Typical cases frequently demonstrate Zollinger-Ellison's syndrome ; that is, ulcers, hyperacidity and the presence of neuroendocrine tumors. These tumor are most commonly found in the duodenum (50-70 %) and less commonly in the pancreas (20-40 %). Those observed in either the duodenum or the pancreas, have greater potentials for malignancy. Most gastrinomas are found in the gastrinomial triangle ; this is bound by the junction of cystic and common bile ducts, the junction of the second and third parts of the duodenum, and the junction of the neck and body of the pancreas. Because complete resection is the key to cures, precise diagnosis of presence and localization is indispensable.
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