Case Report of Gastrinoma Accompanied by Jejunal Perforation

Makoto Takahashi, Hidenori Tsumura, Fumio Matsumoto, Youshi Mikami, Yoshito Iida, Michitoshi Goto, Tomohiko Tokugawa and Nanami Konishi

Department of Surgery, Koshigaya Municipal Hospital

We report a case in which a 46-year-old man with gastrinoma underwent emergency surgery for jejunal ulcer and perforation. Surgery had been conducted for duodenal ulcer and perforation 8 years earlier and for a parathyroid tumor 7 years earlier. The patient was taking oral drugs for duodenal ulcer and underwent emergency surgery for gastrointestinal perforation on June 4, 2003, after the perforation was found in a lesion of the jejunal ulcer. After symptoms were relieved, the patient was diagnosed with gastrinoma, based on the results of a secretin test, abdominal angiography, a selective arterial secretin injection (SASI) test, and serum gastrin (6,514 pg/ml). On August 19, 2003, he underwent pancreatoduodenectomy. Based on the result of a postoperative histological test, the patient was diagnosed with malignant gastrinoma. This case provides a relatively rare example of primary jejunal ulcer and perforation caused by gastrinoma. We re-recognized that it is necessary for patients who are resistant to the anti-ulcer drugs to measure serum gastrin.

Key words
gastrinoma, jejunal ulcer, Zollinger-Ellison syndrome

Reprint requests
Makoto Takahashi Department of Surgery, Koshigaya Municipal Hospital
10-47-1 Higashikoshigaya, Koshigaya, 343-0023 JAPAN

Accepted
October 19, 2004

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