Diagnosis of Gastrinoma: Much Ado about Nothing?

Excerpt

Few disorders have attracted as much clinical interest as duodenal ulcer disease, particularly regarding pathogenesis and treatment. Many gaps remain in our understanding of the pathophysiology of this disease; however, the role of gastric acid is well established. As Karl Schwarz so eloquently stated it in 1910 (1): "Ohne saueren Magensaft, kein peptisches Geschwür": that is, "no acid, no ulcer." Although basal acid production is increased in patients with duodenal ulcer as a group (2), rates vary enormously, and approximately 50% to 60% of patients secrete normal amounts of acid in the basal state (3). Even in these latter