Multiple Duodenal Ulcers with Fatal Hemorrhage

Since the presentation of the Zollinger-Ellison syndrome as a definite clinical entity in 1955,⁹ a significant number of related papers has appeared in the world literature. The fulminating ulcer diathesis associated with non-beta-islet-cell tumors of the pancreas, manifested by marked gastric secretion, multiple ulcer formations and unfavorable response to usual medical-surgical regimens stands accepted. While most authors postulate an endocrine disturbance, the exact mechanisms in this syndrome have not been demonstrated.

After a recent unsuccessful experience with a patient having the Zollinger-Ellison syndrome, we have attempted to analyze our case and the literature to arrive at some conclusions as to treatment which could be expected to improve the results obtained in these cases. The autopsy report on this case further pointed out this need, as the patient had an 8 mm. benign non-beta-isletcell tumor of the head of the pancreas. In addition, we solicited the experienced thinking of a