CA: A Cancer Journal for Clinicians, Vol 39, 231-247, Copyright
© 1989 by American Cancer Society
Primary Peptic Ulcerations of the Jejunum Associated with Islet Cell Tumors of the Pancreas
Robert M. Zollinger MD1 and
Edwin H. Ellison MD2
1 Department of Surgery and the Medical Center of Ohio State University College of Medicine in Columbus, Ohio. Professor and Chairman of the Department of Surgery at that institution for many years.
2 Department of Surgery and the Medical Center of Ohio State University College of Medicine in Columbus, Ohio.
1. Two instances of primary nonspecific jejunal ulcers associated with marked gastric hypersecretion and hyperacidity have been studied. Recurrent ulceration followed standard surgical therapy in both cases and necessitated total gastrectomy.
2. In each patient, nonspecific islet cell tumors of the pancreas were eventually found.
3. Four additional similar cases found in the literature are reviewed.
4. An ulcerogenic humoral factor of pancreatic islet origin is postulated.
5. Theoretical reasons are given for implicating the hyperglycemic-glycogenolytic factor of the pancreas (glucagon).
6. In the one living patient available for study, an electrophoretic analysis of the patient's serum demonstrated a protein fraction with mobility characteristics similar to those of glucagon. This fraction, not found in normal serum, elicited a hyperglycemic response in experimental animals.
7. A clinical entity consisting of hypersecretion, hyperacidity, and atypical peptic ulceration associated with non-insulin-producing islet cell tumors of the pancreas is suggested.
