Zollinger Ellison Syndrome

Drs. Zollinger & Ellison described a disorder of extensive ulcerations within the duodenum and stomach related to massive secretion of stomach acid. This outpouring of acid was found to occur because of a peculiar and unusual tumor usually within the pancreas which sits behind the stomach. This large acid volume is not regulated by the usual mechanisms. It results in persistent progressive ulcers which in the old days eventually killed most patients. Now there are excellent medicines available to stop the acid production, good x-ray techniques to identify the tumor, and surgery to cure the condition. In Image 1, 2 and 3 you see white ulcers scattered across the duodenum.