Læknablaðið - 15.02.1986, Blaðsíða 12

30
LÆKNABLAÐIÐ
diarrhea for 10 years and severe ulcer symptoms for 5
years. Vagotomy and antrectomy in 1980 was unsuccess-
ful. In 1982 se-gastrin measurements were elevated and a
small tumor in the tail of the pancreas was suspected on a
CT-scan. Distal pancreatectomy was done and histology
showed multiple adenomata and hyperplasia of the
Langerhans Islets. The patient remained symptomatic
after the operation and has been controlled on large doses
of Ranitidine. Recently he has developed hyperparathy-
roidismus with markedly raised se-calcium and PTH.
A review of the family history revealed that the father
and two uncles all had unusually complicated ulcer
disease with multiple operations and consequent death. A
review of surgical and postmortem material showed
evidence of multiple endocrine adenomatosis. The
Zollinger-Ellison syndrome in this case is therefore a part
of multiple endocrine adenomatosis type I.
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