Secretory response to secretin in a patient with diarrhoea and the Zollinger-Ellison pattern of gastric secretion

H Petersen , J Myren , I Liavåg

Gut +

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October 1, 1969

View abstract on PubMed

Summary

A woman with Zollinger-Ellison syndrome showed increased duodenal fluid and bicarbonate secretion. This enhanced bicarbonate capacity likely protected her from developing peptic ulcers despite high acid levels.

Area Of Science

Gastroenterology
Endocrinology
Pancreatic Physiology

Background

Zollinger-Ellison syndrome is characterized by gastric acid hypersecretion due to a gastrin-producing tumor.
Patients may present with diarrhea and peptic ulcer disease.
The role of pancreatic bicarbonate secretion in mitigating gastric acid effects is not fully understood.

Purpose Of The Study

To investigate duodenal fluid and bicarbonate secretion in a patient with Zollinger-Ellison syndrome and diarrhea.
To explore the relationship between pancreatic function and the manifestation of peptic ulcer disease in this context.

Main Methods

Secretin stimulation test to measure duodenal fluid and bicarbonate secretion.
Clinical assessment for symptoms of peptic ulcer disease and diarrhea.
Surgical exploration and pancreatic examination.

Main Results

The patient exhibited significantly greater fluid and bicarbonate secretion into the duodenum in response to secretin compared to controls.
No pancreatic tumor was identified, although the pancreas was enlarged.
Peptic ulcer symptoms only appeared after vagotomy and pyloroplasty.

Conclusions

Enhanced pancreatic bicarbonate secretion may serve as a protective mechanism against severe gastric acid hypersecretion.
The patient's ability to tolerate high acid levels was likely due to her increased capacity for duodenal bicarbonate secretion.
Further research is warranted to understand the interplay between pancreatic function and ulcer development in Zollinger-Ellison syndrome.

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