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Surgery Pathophysiology - Neoplasms de982387

Boundaries of Gastrinoma triangle are all EXCEPT:

A
Cystic duct and bile duct junction
B
Junction of second and Third part of duodenum
C
Junction of hepatic ducts
D
Junction of head and neck of pancreas
High-Yield Explanation
ANSWER: (C) Junction of hepatic ductsREF: Sabiston 18th ed chapter 38Gastrinomas were originally assumed to arise in the pancreas, but most subsequent series have shown that the majority originate in the duodenum.Sixty percent to 90% are found in the so-called Gastrinoma triangle, an area in the upper part of the abdomenSuperior point at the junction of the cystic and common bile ductsIts inferior point at the junction of the inferior margin of the second and third parts of the duodenumIts left lateral point at the junction of the head and neck of the pancreas.The duodenum is the site of gastrinomas in more than 60% of patients, and there is a pronounced proximal-to-distal gradient within the duodenum (i.e., most are in the first part, none in the fourth).

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