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Zollinger-Ellison syndrome This is the association of peptic ulcers with a gastrinsecreting adenoma (gastrinoma). Gastrin excites excessive gastric acid production, which may produce multiple ulcers in the duodenum and stomach. The adenoma is usually found in the pancreas, although it may arise in the stomach or duodenum. Most cases are sporadic; 20% are associated with Multiple Endocrine Neoplasia, type 1 (MEN1, p207). 60% are malignant, metastases are found in local lymph nodes and the liver. Symptoms:

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