Caused by hyperplasia of gastric antrum G cells or gastrin-secreting tumors, characterized by hypergastrinemia accompanied by excessive gastric acid secretion leading to upper consumptive thirst and multiple, refractory digestive ulcers in the digestive tract.

bubble_chart Auxiliary Examination

Gastric juice and gastric acid measurement: The total volume of gastric juice over 12 hours at night is >1000 ml. Approximately 66-90% of patients have a basal acid output >15 mmol/hour, and about 50-67% of patients have a BAO/MAO ratio >60%.

Serum gastrin measurement: One-third of patients often have levels exceeding 1000 pg/ml, while about two-thirds have levels between 100-1000 pg/L.

Secretin or calcium stimulation test: If the result is 1-2 times the pre-test value or the absolute value is >500 pg/ml, it suggests gastrinoma.

Gastroscopy and X-ray barium meal examination: May reveal ulcers, hypertrophic mucosal folds, excessive gastric juice, etc.

Tumor localization: Methods such as B-ultrasound, CT, MRI, and angiography can be used.

bubble_chart Diagnosis

Medical history inquiry:

Peptic ulcer symptoms are most common, with poor response to ulcer medications. After subtotal gastrectomy for ulcer, anastomotic ulcers, bleeding, and perforation quickly occur. Diarrhea, passing watery or fatty stools, often accompanies abdominal pain. Manifestations of multiple endocrine neoplasia syndrome, such as hyperparathyroidism, diabetes, etc.

Physical examination findings:

Abdominal tenderness, lack of strength, signs of endocrine tumors.

bubble_chart Treatment Measures

The treatment of gastrinoma should be individualized based on the disease type, stage, overall condition, and economic status.

1. Drug therapy:

   Acid suppression (see peptic ulcer), chemotherapy.

2. Surgical treatment:

   For cases where drug therapy fails or is not feasible, and the tumor location is clearly identified, hospitalization for surgical treatment may be considered.

bubble_chart Differentiation

Duodenal ulcer, pernicious anemia, non-gastrin-producing ulcerogenic islet cell tumor, etc.