Write about Zollinger-Ellison syndrome here.

• Association of peptic ulcer with gastrin-secreting pancreatic adenoma (or simple islet cell hyperplasia)

• Gastrin excites excessive acid production which can produce many ulcers in the duodenum and stomach

• Rarely, adenomas are located in the stomach or duodenum

• 50-60 % are malignant

• 10% are multiple

• 30% of cases are associated with multiple endocrine adenomatosis (MEN 1)

• One third of those with sporadic gastrinomas have a mutation in the MEN1 gene