Laparoscopic diagnosis and cure of hyperinsulinism in two cases of focal adenomatous hyperplasia in infancy.
Persistent hyperinsulinemic hypoglycemia of infancy or congenital hyperinsulinism of the neonate is a rare condition that may cause severe neurologic damage if the disease is unrecognized or inadequately treated. Current treatment aims to restore normal blood glucose levels by providing a carbohydrate-enriched diet and drugs that inhibit insulin secretion. If medical treatment fails, then surgery is required. Because congenital hyperinsulinism may be caused either by diffuse involvement of pancreatic beta-cells or by a focal cluster of abnormal beta-cells, the extent of pancreatectomy varies. We report on 2 patients with a focal form of the disease for whom diagnosis was made with laparoscopy. Laparoscopic enucleation of the lesion was curative.
De Vroede
Monique
M
Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Netherlands. m.devroede@wkz.azu.nl
Bax
N M A
NM
Brusgaard
Klaus
K
Dunne
Mark J
MJ
Groenendaal
Floris
F
D044903:Congenital Hyperinsulinism / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010535:Laparoscopy; D008297:Male; D010179:Pancreas / Q000473:pathology* / Q000601:surgery; D017354:Point Mutation