Recurrent Gastrojejunal Ulceration and Islet-Cell Carcinoma of the Pancreas

The surgical treatment of the complications of duodenal ulcer produces good results in the majority of patients, for only 2% to 5% of such operations fail to relieve the ulcer symptoms. Furthermore, many of the patients who subsequently develop marginal ulceration may obtain permanent relief by further medical management or additional surgical procedures. However, there remains a small group of patients who have such a propensity to develop peptic ulceration that subtotal gastrectomy with or without vagotomy fails to alter the course of the disease, and in some total gastrectomy has been necessary. The etiologic factors which separate these patients from the usual ulcer patient have not been clearly delineated in the past. Consequently, the reports by Ellison and Zollinger concerning the association of non-insulin-producing islet-cell tumors of the pancreas and recurrent peptic ulceration have stimulated interest in the possible relationship of these two lesions.^1,2 We have recently encountered