Zollinger-Ellison syndrome is condition characterised by excessive levels of gastrin, usually from a gastrin secreting tumour usually of the duodenum or pancreas. Around 30% occur as part of MEN type I syndrome

PC:

• multiple gastroduodenal ulcers
• diarrhoea
• malabsorption
• Refractory epigastric pain (from peptic ulcer disease)

Investigations

• fasting gastrin levels: the single best screen test
• secretin stimulation test

A diagnosis is made with elevated serum gastrin at least 10 times the upper limit of normal, a reduced gastric pH, and a secretin stimulation test if those criteria are not met.