Gastric Secretion With Ulcerogenic Islet Cell Tumor

AN INCREASING proportion of patients with peptic ulcer due to gastrin-producing islet cell tumor are being recognized in whom features of the syndrome are atypical or delayed in onset.¹⁻⁴In such instances, identifying the tumor and establishing its causal relationship with the ulcer²,⁴⁻⁶may involve complex surgical and biochemical methods.⁷,⁸The purpose of this paper is therefore to investigate the diagnostic importance of gastric secretory findings. Zollinger and Ellison⁹originally emphasized abnormally high nocturnal gastric secretion as characteristic of this syndrome, a finding confirmed by others.¹⁰Summerskill¹¹found a greatly increased one-hour basal acid output which approximated unusually the acid response to an augmented dose of histamine. Rawson and co-workers¹²and Marks and associates¹³reported similar results, and Marks and colleagues proposed that the ratio of basal to maximal acid secretion would be useful in diagnosis of the syndrome.¹³Information included in many subsequent case