Zollinger-Ellison Syndrome

The association of endocrine gland adenomata and peptic ulceration has been recognized for some time. Zollinger and Ellison in 19551described a syndrome consisting of multiple recurrent peptic ulcerations, gastric hypersecretion, and non-beta islet cell tumor of the pancreas. Subsequently, these and other authors have delineated this syndrome further.2-7 The present review of 86 documented cases of the Zollinger-Ellison syndrome2,3,6-57was prompted by, and includes, a recent case of our own57in which unusual features provide evidence for the theory of extrapancreatic stimulation as an etiologic factor in the Zollinger-Ellison syndrome. Although this syndrome has received much attention, the diagnosis was suspected preoperatively in only 22% of the case reports reviewed and the mortality rate was 54%. Because of the grave prognosis and the infrequency with which diagnosis is made on clinical grounds, this report is compiled to define the syndrome by analyzing the reviewed cases