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SERGIO PEDRAZZOLI, MD; PIERO PETRIN, MD; CLAUDIO PASQUALI, MD; CARMELO MILITELLO, MD; COSIMO SPERTI, MD; VALTIERO FREGONESE, MD; GIUSEPPE SIMINI, MD
Padua, Italy

Arch Surg. 1983;118(2):256.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—Cimetidine-associated mental confusion is described in elderly patients, patients with renal or hepatic failure, or patients given high doses of the drug.¹ Moreover, cimetidine can delay the clearance of benzodiazepines that are administered to reduce mental confusion.² Patients treated with ranitidine instead have never shown mental impairment.

Report of a Case.—A 57-year-old woman experienced mental confusion and coma while treated with large doses of cimetidine (4 g/day). Her condition was diagnosed as Zollinger-Ellison syndrome (ZES) with anastomotic peptic ulcer, on the basis of an increase in the blood gastrin level to 1,200 pg/mL after an intravenous injection of secretin (1 clinical unit/kg). Basal acid output was 6.8 mEq/hr. Celiac trunk and superior mesenteric arteriography showed a tumor stain of 3 to 4 cm in the head of the pancreas, but transhepatic portal catheterization did not show serious gastrin variations. Duodenopancreatectomy was performed, but postoperative . . . [Full Text PDF of this Article]

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