J.Jpn. Surg. Soc.. 83(4): 378-383, 1982

---

Original article

PEPSIN ACID CORRELATION IN PEPTIC ULCER
－INCLUDING DIFFERENTIAL DIAGNOSIS FROM ZOLLINGER-ELLISON SYNDROME

Histamine and insulin stimulated pepsin acid correlation was studied to elucidate the pathogenesis of peptic ulcer, using 43 patients with gastric ulcer, 18 with combined gastric and duodenal ulcers, 51 with duodenal ulcer, one with Zollinger-Ellison syndrome, and 12 with healthy adults. Pepsin acid correlation expressed as PPO/PAO×10 was calculated from peak acid output (PAO) and peak pepsin output (PPO). The results obtained are as follows :
1) In gastric ulcer, combined ulcers, duodenal ulcer, and healthy adults, histamine stimulated PPO/PAO×10 rations were 2.4±0.2, 1.8±0.4, 1.4±0.1, and 1.6±0.2 respectively, and insuline stimulated PPO/PAO×10 rations were 4.1±0.4, 3.1±0.5, 2.2±0.2 and 2.8±0.8, respectively. Therefore, PPO/PAO×10 differed among the diseases, being higher in gastric ulcer followed by combined ulcers, healthy adults and then duodenal ulcer. These results indicate that in gastric ulcer pepsin secretion is dominant, however,in duodenal ulcer acid secretion is dominant.
2) In Zollinger-Ellison syndrome, histamine and insulin stimulated PPO/PAO×10 showed always less than 1.0 both before and after vagotomy. As this value was the least among the diseases studied, acid secretion is more dominant in Zollinger-Ellison syndrome than that in duodenal ulcer.
3) From these results, it is concluded that when histamine and insulin stimulated PPO/PAO×10 is less than 1.0, Zollinger-Ellison syndrome could be most suspected.

---

---

To read the PDF file you will need Adobe Reader installed on your computer.