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Gastric cancer is a worldwide cancer especially frequent in Japan and South America. This cancer affects 10 to 70 people per 100,000 according to the countries. Since the end of the Second World War, the incidence of gastric cancer has been decreasing in France and accounts for less than 10 % of mortality. Helicobacter pylori infection, host genetic background, food regimen are known to be involved in this cancer. Helicobacter pylori should be eradicated in selected patients, such as patients' relatives with documented gastric cancer as well as patients having another gastrointestinal cancer.

Gastric carcinoid tumors are divided up into three groups of various presentation and prognosis. Carcinoids tumors on fundic atrophic gastritis with achlorhydria resistant to pentagastrine stimulation, the most numerous, and those observed in patients with Zöllinger-Ellison syndrome, are fundic, readily small and numerous, of slow evolution with rare metastasis and without carcinoid syndrome. They are associated with an hypergastrinemia of antral or tumoral origin, responsible for a diffuse endocrin hyperplasia upon which they rest. The other carcinoid tumors, called sporadic, are usually unique and more voluminous, much more aggressive. They are accompanied by a carcinoid syndrome in one third of the cases. They occur without any hypergastrinemia and rest on a entirely normal gastric mucosa. The diagnosis of gastric carcinoid tumor imperatively requires an assessment intended to classify the tumors and to set up therapeutic indications.

The megaloblastic anaemia observed in patients with chronic atrophic gastritis is usually due to malabsorption of vitamin B12. In some cases, the absence of intrinsic factor supports the diagnosis of pernicious anaemia but other factors, the importance of which varies from case to case, are also involved. They include proliferation of bacteria in the lumen of the gut, intestinal cell abnormalities resulting from lack of vitamin B12 and low hydrochloric acid output with subsequent reduction in the release of vitamin B12 from foodstuffs. With regard to treatment, it would seem justified to combine oral broad-spectrum antibiotics with parenteral administration of vitamin B12.

Two cases of intestinal perforation due to necrotising enteritis in patients with pica are presented. The aetiopathogenesis of pica is discussed as well as its role in the development of necrotising enteritis.

We report a case of chronic diarrhea due to hypergastrinemia with achlorhydria but without gastritis in a five-year-old boy. Symptoms responded promptly to oral administration of hydrochloric acid and resolved completely after one year of treatment. The pathophysiologic situation in this patient closely resembled that normally seen in neonates, suggesting prolonged but nevertheless transient immaturity of gastric secretions.