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Recognition of the Complete Clinical Spectrum and Its Management

Robert M. Zollinger, MD; Fred T. Moore, MD

JAMA. 1968;204(5):361-365.

Abstract
The non-beta islet cell tumor of the pancreas is associated with a variety of clinical symptoms. These tumors as well as their metastases can produce a potent gastrinlike hormone responsible for marked gastric hypersecretion and a fulminating ulcer diathesis, with or without diarrhea. Less commonly, these tumors may be associated with a severe diarrhea in the absence of gastric hypersecretion or peptic ulceration. The relatively fixed concentration of hydrochloric acid in the control and following the augmented histamine test and the Lai rat bioassay can be of diagnostic value. The potential of the non-beta islet cell tumor of the pancreas to produce more than one hormone is suggested from the case reports. The treatment of peptic ulcer may eventually be improved by systemic measures designed to control the hormones responsible for gastric hypersecretion.

Author Affiliations
From the Department of Surgery and the Surgical Laboratories, Ohio State University College of Medicine, Columbus.

Footnotes
Reprint requests to 410 W Tenth Ave, Columbus, Ohio 43210 (Dr. Zollinger).

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