Antral Gastrin Cell Hyperfunction Associated with Chronic Pancreatitis

Abstract

This report describes a patient with antral gastrin cell hyperfunction who also had pancreatic pseudocyts and partial common bile duct obstruction secondary to chronic pancreatitis. A 60-year-old female had a th ree-month h istory of worsening epigastric discomfort with episodes of nausea, vomiting and weight loss. The patient had no history of peptic ulcer disease and no ulcers were demonstrated during diagnostic work-up. Baseline fasting serum gastrins were 715 and 1000 pg/ml [normal 50 to 170 pg/ml). These decreased to 515 pg/ml during an intravenous secretin test and increased up to 2155 pg/ml after a protein meal test. The patient also had chronic pancreatitis, multiple pancreatic pseudocysts and a partial common bile duct obstruction. Truncal vagotomy and antrectomy for antral gastrin cell hyperfunction. Roux-en-Y cystjejunostomy for pancreatic pseudocysts and choledochojejunostomy for common bile duct stricture were performed. Three months after the operation, the patient was symptom-free and fasting serum gastrin levels at one week, two months and three months after the surgery were 11, 40 and 50 pg/ml, respectively.