Antral Gastrin Cell Hyperfunction Associated with Chronic Pancreatitis

Abstract

ABSTRAC T: T h is report describes a patient with antral gastrin cell hyperfunction who also had pancreatic pseudocy:m and partial common bile duct obstruction secondary ro ch ron ic pancreatitis. A 60-year-old female had a th ree-month h istory of wor~ening epigastric discomfort with episodes of nausea, vomiting and weigh t loss. The patient had no history of peptic ulcer d isease and no ulcers were demonstrated during diagnostic work-up. Baseline fasti ng serum gastrins were 715 and 1000 pg/ml [normal 50 to 170 pg/m l). These decreased to 515 pg/ml du ring an in travenous secreti n test and increased up to 2 155 pg/ml after a protein meal test. The patient also had chronic pancreatitis. multiple pancreatic pseudocysts and a partial common bile duct obstruction. Tru ncal vagotomy and antrectomy fo r antral gastrin cell hyperfunction. Roux-en-Y cyscjejunostomy for pancreatic pseudocysts and choledochojejunostomy for common bile duct stricture were performed. Th ree mon ths after the operation. the patient was symptom-free and fasting serum gastrin levels at one week, two months and three mon ths after the su rgery were ll, 40 and 50 pg/ml, respectively. Ca n J Gasti:oe nte rol 1988;2(3):123-1 26.Key W o rds: A nrral gasrrm cell hyperJ1me11on. Chronic pancreaii11s