Duodenal stenosis from intramural cystic annular pancreas.

A case of annular pancreas presenting with duodenal obstruction due to overfilling of a large intramural duodenal cyst is reported. At 30 years of age, this man was an alcoholic with repeated attacks of pancreatitis which produced the enlargement of an annular pancreas and the development of a cyst probably through blocking of an aberrant duct. The surgical operation consisted of simply removing part of the external cyst wall and outer anterior layer of the duodenum.

[Postoperative hypergastrinemia].

After reviewing the more recent acquisitions on the physiology and pathophysiology of gastrin, the authors concentrate on situations of hypergastrinemia, which they divide into a hyperhydrochloric and a hypohydrochloric variety. Among the former, which they subdivide into preoperative and postoperative, the authors discuss problems of differential diagnosis versus peptic ulcers in patients so afflicted. To that end they propose diagnostic policies comprising among other instrumental and laboratory tests the study of gastric secretion, blood gastrin levels in basal conditions and after stimulation by a protein meal, BBS, secretin, and calcium.