Diagnosis of Gastrinoma: Much Ado about Nothing?
Authors: M. Michael Wolfe
Journal: Annals of Internal Medicine (1989)

Editorials1 November 1989Diagnosis of Gastrinoma: Much Ado about Nothing?M. Michael Wolfe, MDM. Michael Wolfe, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-111-9-697 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptFew disorders have attracted as much clinical interest as duodenal ulcer disease, particularly regarding pathogenesis and treatment. Many gaps remain in our understanding of the pathophysiology of this disease; however, the role of gastric acid is well established. As Karl Schwarz so eloquently stated it in 1910 (1): "Ohne saueren Magensaft, kein peptisches Geschwür": that is, "no acid, no ulcer." Although basal acid production is increased in patients with duodenal ulcer as a group (2), rates vary enormously, and approximately 50% to 60% of patients secrete normal amounts of acid in the basal state (3). Even in these latter...References1. Schwarz K. Ueber penetrierende magen-und jejunalgeschwüre. Beitr Klin Chir. 1910;67:96-128. Google Scholar2. Feldman M and Richardson C. Total 24-hour gastric acid secretion in patients with duodenal ulcer: comparison with normal subjects and effects of cimetidine and parietal cell vagotomy. Gastroenterology. 1986;90:540-4. CrossrefMedlineGoogle Scholar3. Blair A, Feldman M, Barnett C, Walsh J, and Richardson C. Detailed comparison of basal and food-stimulated gastric acid secretion rates and serum gastrin concentrations in duodenal ulcer patients and normal subjects. J Clin Invest. 1987;79:582-7. CrossrefMedlineGoogle Scholar4. Wolfe M and Jensen R. Zollinger-Ellison syndrome: current concepts in diagnosis and management. N Engl J Med. 1987;317:1200-9. CrossrefMedlineGoogle Scholar5. Stage J and Stadil F. The clinical diagnosis of the Zollinger-Ellison syndrome. Scand J Gastroenterol Suppl 1979;53:79-91. MedlineGoogle Scholar6. 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Frucht H, Howard J, and Slaff J. Secretin and calcium provocative tests in the Zollinger-Ellison syndrome: a prospective study. Ann Intern Med. 1989;111:713-22. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: M. Michael Wolfe, MDAffiliations: Brigham and Women's Hospital Boston, Massachusetts Nextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySerum Gastrin in Zollinger-Ellison SyndromeZollinger-Ellison syndromeGastric Secretion in Zollinger-Ellison SyndromeCatalytic transformations of sulfur dioxide into organic sulfur compoundsZollinger-Ellison syndrome and antral G-cell hyperfunction in patients with resistant duodenal ulcer diseaseSurgery of Endocrine Tumours of the PancreasZollinger-Ellison Syndrome 1 November 1989Volume 111, Issue 9Page: 697-699KeywordsDuodenal ulcersPathogenesisUlcers ePublished: 1 December 2008 Issue Published: 1 November 1989 PDF downloadLoading ...