title: Nesidioblastosis with hyperinsulinemic hypoglycemia in adults: report of two cases.
abstract: 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.
authors.affiliation: Department of Surgery, Kurume University School of Medicine, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Eriguchi
authors.forename: S
authors.initials: S
authors.lastname: Aoyagi
authors.forename: M
authors.initials: M
authors.lastname: Hara
authors.forename: E
authors.initials: E
authors.lastname: Tanaka
authors.forename: M
authors.initials: M
authors.lastname: Hashimoto
authors.forename: A
authors.initials: A
authors.lastname: Jimi
mesh_terms: 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