Gastrinomas and the change in their presentation and management in Northern Ireland, UK, from 1970 to 1996

Thirty-five new cases of gastrinomas were diagnosed in N. Ireland between 1 970 and 1996, Over this period, patient care has improved, with advances in imaging techniques and therapeutic regimens. Patients are now no longer pr esenting in the classical way with severe ulcer diathesis, Diarrhoea is oft en a major feature, occurring in 46% of patients. Thirty-one percent of pat ients presented with mixed amine precursor, uptake and decarboxylation (APU D) tumours, Survival has improved, most likely as a result of better detect ion of tumours, as well as treatment that is aimed at resection and removal of the gastrinoma, The advent of proton pump inhibitors has ensured sympto m control in those for whom total tumour removal is impossible. Owing to im proved survival, metastatic complications are often associated with patient mortality. Eur J Gastroenterol Hepatol 10:947-952 (C) 1998 Lippincott Will iams & Wilkins.