Islet tumours of the pancreas with intractable diarrhoea

Telling, Mark; Smiddy, F. G.

doi:10.1136/gut.2.1.12

Cited by 34 publications

(6 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus of 30 ulcers in 24 patients described by Ellison (1956), six were in the second part of the duodenum, three in the third part, and four in the jejunum. Zollinger and Elliott (1959) described two patients with perforating jejunal ulcers; intestinal malabsorption caused by jejunal ulceration is now a wellrecognized part of this syndrome (Summerskill, 1959), although it can be caused by other mechanisms (Telling and Smiddy, 1961).…”

Section: Discussionmentioning

confidence: 99%

Gastric epithelium in the duodenum

James¹

1964

Gut

143

View full text Add to dashboard Cite

EDITORIAL SYNOPSIS It has been found that a 'gastric' type of epithelium tends to develop in the first part of the duodenum in patients with duodenal ulceration and is found in the second part of the duodenum in a patient with the Zollinger-Ellison syndrome. It is likely that 'gastric' epithelium appears when the duodenal acidity is high and it is resistant to ulceration.The stomach is normally lined by one kind of epithelium and the duodenum by another. Islands of intestinal epithelium have long been known to occur in the stomach, particularly when gastric acidity is low: this paper describes islands of gastric epithelium in the duodenum; they are especially common when gastric, and hence duodenal, acidity is high. These anomalies mirror each other, and the conditions which bring them about throw light, it will be suggested, upon the pathogenesis of peptic ulceration and the determination of its site.Taylor (1927), reviewing heterotopia in the alimentary tract, described two instances of gastric epithelium in the duodenum. They were found among 150 necropsies, and were recognizable as slightly raised patches. Histological examination showed these to be covered by well-preserved gastric epithelium and to contain gastric glands with both chief and parietal cells; Brunner's glands were absent from the patches. In both cases the patches were found in the first part of the duodenum near the pylorus, and in one there was a duodenal ulcer. The presence of gastric glands places these patches in a different category from those described in this paper, where only the epithelium was abnormal. Patzelt (1936) reviewed the histology of the pyloro-duodenal region in animals and man and quoted descriptions which showed that the line of epithelial demarcation was not always sharp, there being islands of intestinal epithelium on the gastric side of the pylorus and, much more rarely, of gastric epithelium on the intestinal side. His article contains an illustration of one such 'Magenepithelinsel' found in the duodenum of a woman; the island appears to cover an inflammatory polyp containing a lymph follicle; no gastric glands were present.

show abstract

Section: Discussionmentioning

confidence: 99%

Gastric epithelium in the duodenum

James¹

1964

Gut

143

View full text Add to dashboard Cite

show abstract

“…The mechanism of production of the diarrhoea remains obscure in these cases and the existence of another hormone, originally suggested by Telling and Smiddy (1961), seems most likely. Attempts by experiments in vitro to demonstrate that extracts from these tumours can affect intestinal absorption and secretion of fluid and electrolytes have not met with success (Matsumoto et al, 1966).…”

mentioning

confidence: 98%

Effect of a synthetic gastrin-like pentapeptide upon the intestinal transport of sodium, potassium, and water.

Gingell¹,

Davies²,

Shields³

1968

Gut

View full text Add to dashboard Cite

“…That there is a minimal dose of steroid necessary to suppress diarrhoea has been shown in a review of the literature by Marks et al (1967) and we found we had to exceed this minimum dose of 15-20 mg of W 1 W d Pancreatic islet cell tumour with watery diarrhoea and hypokalaemia prednisolone or equivalent ACTH dosage by considerable amounts during relapses ofdiarrhoea thus producing the complications that follow the long-term use of such high doses. We did not see the commonest reported complication, gastrointestinal bleeding (Priest and Alexander, 1957;Chears et al, 1960;Telling and Smiddy, 1961).…”

Section: Observations On Faecal Fluid and Electrolyte Lossesmentioning

confidence: 82%