Most common presentation of gastrinoma/ZES:March 2013 (f, h)

Ans. B i.e. Duodenal ulcerGastrinomaIt is a tumor in the pancreas or duodenum that secretes excess of gastrin leading to ulceration in the duodenum, stomach and the small intestine.There is hypersecretion of the HC1 in the duodenum which causes the ulcers.HC1 also causes hyperperistalsis and inhibits the activity of lipase causing severe diarrhoea.It is most commonly found in the duodenum (50-70%) and less commonly in the pancreas (20-40%).Those occurring in the pancreas have a greater potential for malignancy.Most gastrinomas are found in the gastrinoma triangle; which is bound by:- Junction of cystic and common bile ducts, Junction of the second and third pas of the duodenum, and the Junction of the neck and body of the pancreas.