Zollinger-Ellison syndrome historical perspective

In 1955, Zollinger and Ellison published their seminal paper on gastrinomas wherein the Zollinger-Ellison syndrome was discussed for the first time.

• In 1955, Zollinger and Ellison announced their concept about ulcerogenic islet cell tumor which caused marked ulcer diathesis due to gastric hyperacidity.^[1]
• Dr. Robert M. Zollinger and Dr. Edwin H. Ellison announced their theory at the annual meeting of American Surgical Association in Philadelphia in April 1956.^[2]
• This concept raised from clinical case of two women who presented with perforated jejunal ulcers accompanied with severe ulcer diathesis.
• One of the patients was a 36 year-old woman with past history of 8 years abdominal pain and diarrhea. A laparotomy revealed perforated jejunal ulcers with severe recurrent hemorrhage. Although she underwent two subtotal gastric resections, transabdominal vagotomy, and transthoracic vagotomy, her symptoms were constantly persistent. Finally she underwent total gastrectomy; however, she died due to anastomic leakage from the surgery. Her autopsy was in favor of non-beta pancreatic islet cell tumor.^[3]
• The other patient was a 19 year-old woman with 2 years of upper abdominal pain. She underwent a surgery in July 1953 and was diagnosed with two perforated jejunal ulcers. A truncal vagotomy and a radical subtotal gastrectomy were performed in January 1954. This operation was called a dream operation for ulcers by Zollinger. Due to unsuccessful results of the operation, she had to go through radiation therapy to her stomach. Eventually, total gastrectomy was performed. The results described a non-beta islet cell carcinoma with lymph node metastasis.
• In 1956, Ben Eiseman of Denver, Colorado, presented the same experience with one of his patients and called the condition “Zollinger-Ellison syndrome”.^[4]
• Discovery of insulinoma in 1927 and malignant carcinoid syndrome in 1953, have exceeded the presentation and discovery of Zollinger-Ellison syndrome.^[5][6]
• In the 1960s, gastrin was described to be involved in the pathogenesis of gastric hyperacidity by Dr. Lester.^[7]
• Roderic Gregory and Hilda Tracy of Liverpool proved that gastrin is the cause of Zollinger-Ellison syndrome. ^[8]
• Radioimmunoassay was developed for assessment of gastrin level in 1967 and 1968.^[9][10]
• Histamine-2 blocking drugs (H2) were introduced as the first effective medical therapy for Zollinger-Ellison syndrome in 1975.^[11]

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