title: Hypergastrinemia and a duodenal ulcer caused by gastric duplication.
abstract: BACKGROUND
  Hypergastrinemia and the resultant peptic ulcer related to an enteric duplication has been quite rarely reported in the literature.
  
  
  METHODS
  We herein report the case of a 4-year-old girl who presented with hypergastrinemia and a duodenal ulcer at 2 years of age. She had been followed up with a proton pump inhibitor, which resulted in resolution of the ulcer; however, unexplained hypergastrinemia had continued. A cystic lesion at the antrum was discovered at 4 years of age, which we suspected to be a gastric duplication. After we resected the lesion, the hypergastrinemia resolved without recurrence of the duodenal ulcer. The histology was compatible with a gastric duplication, and the lumen was lined with antral mucosa that strongly stained positive for gastrin. We presumed that the antral mucosa inside the duplication in our case had no hydrogen ion feedback inhibition of gastrin release from gastrin cells and increased release of gastrin from the mucosa inside the duplication led to the duodenal ulcer. Only two cases have been reported in the literature that had hypergastrinemia related to enteric duplication.
  
  
  CONCLUSIONS
  Gastric duplication should be included in the differential diagnosis of sustained hypergastrinemia in children.
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki Prefecture, 305-8575, Japan. tanaka-h@md.tsukuba.ac.jp.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki Prefecture, 305-8575, Japan.
authors.forename: Kouji
authors.initials: K
authors.lastname: Masumoto
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki Prefecture, 305-8575, Japan.
authors.forename: Takato
authors.initials: T
authors.lastname: Sasaki
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki Prefecture, 305-8575, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Sakamoto
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki Prefecture, 305-8575, Japan.
authors.forename: Chikashi
authors.initials: C
authors.lastname: Gotoh
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki Prefecture, 305-8575, Japan.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Urita
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki Prefecture, 305-8575, Japan.
authors.forename: Toko
authors.initials: T
authors.lastname: Shinkai
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki Prefecture, 305-8575, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Takayasu
authors.affiliation: Department of Pathology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki Prefecture, 305-8575, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Nakano
authors.affiliation: Department of Pathology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki Prefecture, 305-8575, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Noguchi
authors.affiliation: Department of Pediatrics, Ibaraki Children's Hospital, 3-3-1 Futabadai, Mito, Ibaraki Prefecture, 311-4145, Japan.
authors.forename: Toyoichiro
authors.initials: T
authors.lastname: Kudo
keywords: Child; Duodenal ulcer; Duplication cyst; Hypergastrinemia; Stomach