Antral gastrin cell hyperfunction associated with chronic pancreatitis

This report describes a patient with antral gastrin cell hyperfunction who also had pancreatic pseudocysts and partial common bile duct obstruction secondary to chronic pancreatitis. A 60-year-old female had a three-month history 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 symtom-free and fasting serum gastrin levels at one week, two months and three months after the surgery well 11, 40 and 50 pg/mL, respectively.