This syndrome was first described in 1955, but the reason it was not known. To date, found that the formation of ulcers in this syndrome is caused by a tumor that produces the hormone gastrin. Gastrin - a hormone substance that stimulates production of hydrochloric acid and pepsin. Most often the tumor is located in the head or body of the pancreas (90%), rarely in the stomach and duodenum, and liver. In most cases, gastrinoma is a malignant tumor.
Appears Zollinger-Ellison syndrome formation of ulcers in the duodenum, at least in the stomach. Ulcers are formed under the influence of enhanced aggressiveness of gastric contents, as under the action of gastrin in the stomach is a large amount of hydrochloric acid and pepsin.
These ulcers are usually multiple and difficult to treat. The patient is concerned about persistent heartburn and acid regurgitation. As contained in the stomach hydrochloric acid is neutralized does not have time, it enters the duodenum and small intestine. The normal acidity of the intestinal contents is increased, the pH decreases. This manifests itself in the gut malabsorption of nutrients and abundant liquid diarrhea. The patient may lose weight significantly, especially if the tumor is malignant.
Often, Zollinger-Ellisonsyndrome is accompanied by diseases of the esophagus, and the seam of his restrictions. On examination, the abdomen and palpation revealed tenderness in the stomach, sometimes muscle strain detected the anterior abdominal wall above the ulcer.
When X-ray and endoscopy reveal an ordinary ulcer. If you suspect a Zollinger-Ellison syndrome is carried ultrasound of the abdomen and computed tomography. These studies help to identify the tumor a little more than half of the patients, especially if the tumor size less than 1 cm in order to clarify the diagnosis performed selective angiography of abdominal and simultaneous sampling of blood from the veins of the pancreas with the definition of gastrin in the blood.
