Zollinger-Ellison Syndrome

Few clinical states have aroused more interest and curiosity among physicians than has the Zollinger-Ellison syndrome. In the eight years since its description in 1955, pathologists, physiologists, and clinicians have become very much aware of the intriguing relationship between endocrinopathy and peptic ulceration despite the fact that the syndrome is infrequently encountered. In 1954 Wermer¹⁸ called attention to the high incidence of peptic ulceration in patients having polyendocrine adenomatosis, but it was the report of Zollinger and Ellison²³ a year later which stimulated great interest in the syndrome consisting of fulminating peptic ulceration, gastric hyperacidity, and pancreatic islet-cell adenomas. It is now known that multiple endocrine glands are involved in 20% to 30%^8,11 of patients presenting with this clinical state, and it is probable that this figure is conservatively low. Approximately 70 instances of polyendocrine adenomatosis have been reported, and most of the recent reports have been