Nesidioblastosis with hyperinsulinemic hypoglycemia in adults: report of two cases.
We report herein the cases of two women, aged 34 years and 39 years, respectively, found to have hyperinsulinemic hypoglycemia after presenting with a history of episodes of temporary loss of consciousness, nausea, and fainting. Under the suspected diagnosis of insulinoma, localization procedures were carried out, but no tumor was found. In both patients, a definite gradient in insulin concentration was found in the pancreas by percutaneous transhepatic or intraoperative portal venous sampling, and a misdiagnosis of insulinoma of the pancreatic body was made. During exploratory laparotomy no tumor was palpable in the pancreas, and intraoperative ultrasonography showed no low echoic mass in the pancreas. A distal pancreatectomy was performed in both patients, and histopathological examination of the resected specimens revealed graded slight hyperplasia of the islet cells.
Eriguchi
N
N
Department of Surgery, Kurume University School of Medicine, Japan.
Aoyagi
S
S
Hara
M
M
Tanaka
E
E
Hashimoto
M
M
Jimi
A
A
D000328:Adult; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications*; D007003:Hypoglycemia / Q000150:complications*; D007515:Islets of Langerhans / Q000473:pathology; D010180:Pancreatectomy; D010182:Pancreatic Diseases / Q000150:complications* / Q000473:pathology / Q000601:surgery