title: Peritoneal dialysis masking symptoms of an insulinoma uncovered during the perioperative period: a case report.
abstract: A 61-year-old male with a chronic history of renal insufficiency treated with peritoneal dialysis (PD) was discovered to be asymptomatic for an occult insulinoma after peripheral revascularization. The patient's near continuous provision of glucose in the PD fluid acted to conceal symptoms of an insulinoma which was revealed when PD was interrupted. The patient had delayed emergence from general anesthesia resolving with glucose administration, precipitating insulinoma work up.
authors.affiliation: Department of Anesthesiology, Lebanon Nephrology and Hypertension Renal Dialysis, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, USA. robert.jarrett@hitchcock.org
authors.forename: Robert A
authors.initials: RA
authors.lastname: Jarrett
authors.forename: Clay A
authors.initials: CA
authors.lastname: Block
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D007340:Insulinoma / Q000175:diagnosis* / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D010530:Peritoneal Dialysis