Incidence
Age
Sex
Geography
Aetiology	- arise from G-cells in pancreas - secrete gastrin -> peptic ulceration in stomach, duodenum and jejunum - ulcers are often large and deep; may be multiple
Presentation	- peptic ulcer - diarrhoea due to low pH in upper intestine
Investigations	Acid studies - high acid output USS / CT / isotope scans (labelled octreotide) / local venous sampling (for gastrin) - demonstrate tumour - isotope scans are first-line - also demonstrate metastases
Macro
Micro
Staging
Serum markers	- high serum gastrin provides diagnosis
Management	Medical - proton pump inhibitor - octreotide while diagnosis is being made Surgical - for removal of primary only
Prognosis	- slow-growing - patients die of malgnancy unless primary can be removed
Complications	- ulcers may haemorrhage or perforate

Hepatobiliary medicine

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