In a patient with Zollinger-Ellison syndrome, the anatomical region bounded by the confluence of the cystic duct and common bile duct superiorly, the second and third parts of the duodenum inferiorly, and the neck and body of the pancreas medially is significant because:

• A Over 70 percent of gastrinomas arise within it, most commonly in the duodenal wall ✓
• B It contains the majority of insulinomas, which cluster near the superior mesenteric vessels
• C Pancreatic head cancers arising there are uniformly resectable
• D It marks the site of ectopic splenic tissue prone to lymphoma

Explanation

This is the gastrinoma triangle, described by Stabile, in which the great majority of gastrinomas are found. Sporadic tumours are most often located in the duodenal wall rather than the pancreas, a fact that changed surgical strategy toward duodenotomy and careful exploration. Insulinomas show no such clustering, and pancreatic head malignancy at this site is frequently unresectable at presentation.

Reference: Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.