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Use of Calcium and Secretin in the Diagnosis of Gastrinoma (Zollinger-Ellison Syndrome)
- CLIFFORD W. DEVENEY, M.D.;
- KAREN S. DEVENEY, M.D.;
- BERNARD M. JAFFE, M.D., F.A.C.S.;
- RAYFORD S. JONES, M.D., F.A.C.S.; and
- LAWRENCE W. WAY, M.D., F.A.C.S.
Abstract
Sixty-five patients with peptic ulcer disease were evaluated for gastrinoma (Zollinger-Ellison syndrome) by measuring changes in serum gastrin concentration after intravenous (i.v.) administration of calcium or secretin, or both. The presence of gastrinoma was established in all 20 patients whose serum gastrin increased by 395 pg/ml or more after i.v. calcium and in all 18 patients whose serum gastrin concentration increased by 110 pg/ml or more after i.v. secretin. The experience with these 65 patients shows that stimulation by calcium or secretin may confirm the presence of gastrinoma in cases where the diagnosis would otherwise remain obscure. Although a positive response to calcium or secretin is diagnostic for gastrinoma a negative response does not exclude this diagnosis. Stimulation with secretin is preferred for screening for gastrinoma because it is quicker and more reliable than calcium.
Article and Author Information
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▸From the Surgical Service, Veterans Administration Hospital, and the Department of Surgery, University of California, San Francisco, California; Washington University, St. Louis, Missouri; and Duke University, Durham, North Carolina.
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Grant support: by the Medical Research Service of the Veterans Administration.
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▸Requests for reprints should be addressed to Clifford W. Deveney, M.D.; Surgical Service (112), Veterans Administration Hospital; 4150 Clement Street; San Francisco, CA 94121.
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- Received January 21, 1977.
- Accepted August 12, 1977.
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