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Antral hypergastrinemia--a report of three cases
J Poulsen1, P Delikaris, L I Larsson
1Department of Surgical Gastroenterology, Kommunehospitalet, Arhus University, Denmark.
Digestion
|January 1, 1987
Summary
This study investigates hypergastrinemia in patients with juxtapyloric ulcers. Elevated gastrin levels and altered gastrin cell distribution were observed, persisting after initial surgery but resolving with antrectomy.
Area of Science:
- Gastroenterology
- Endocrinology
- Surgical Pathology
Background:
- Juxtapyloric ulcers are often associated with elevated gastrin levels.
- Understanding the role of gastrin in ulcer pathogenesis is crucial for effective treatment.
Observation:
- Three patients with juxtapyloric ulcers and hypergastrinemia were studied.
- Serum gastrin concentrations (SGC) were significantly elevated both in fasting and postprandial states.
- Gastric acid secretion was within normal limits despite hypergastrinemia.
Findings:
- Selective gastric vagotomy and Jaboulay gastroduodenostomy (SGV + GD) resulted in minimal reduction in acid secretion and persistent hypergastrinemia.
- Immunocytochemical analysis revealed increased gastrin cell numbers and distorted topography in the antropyloric glands.
- Antrectomy effectively reduced serum gastrin levels and abolished postprandial gastrin response, resolving recurrent ulcers.
Implications:
- Hypergastrinemia in juxtapyloric ulcers may indicate underlying gastrin cell abnormalities.
- Standard ulcer surgery may not adequately address hypergastrinemia, potentially leading to recurrence.
- Antrectomy appears to be an effective treatment for hypergastrinemia-associated juxtapyloric ulcers with recurrent disease.
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