title: Adult onset nesidioblastosis treated by subtotal pancreatectomy.
abstract: BACKGROUND
  Nesidioblastosis is a rare cause of non insulinoma pancreatogenous hypoglycemic syndrome seen in adults. It is characterized by postprandial hypoglycemia with high insulin and C-peptide levels without any detectable pancreatic lesion. The definitive diagnosis can be made only on histopathological examination of the resected specimen.
  
  
  METHODS
  We report a case of a 50-year-old lady presenting with hypoglycemic attacks being misdiagnosed preoperatively as insulinoma and treated with enucleation leading to recurrence of symptoms after 6 months. Later medical therapy was tried which failed and patient needed subtotal pancreatectomy for resolution of symptoms.
  
  
  CONCLUSIONS
  Nesidioblastosis should be suspected in patients with endogenous hyperinsulinemic hypoglycemia without any detectable pancreatic tumor on preoperative imaging.
authors.affiliation: Department of Surgical Gastroenterology, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India. rahul.g.85@gmail.com
authors.forename: Rahul Amreesh
authors.initials: RA
authors.lastname: Gupta
authors.forename: Roma Prahladbhai
authors.initials: RP
authors.lastname: Patel
authors.forename: Sanjay
authors.initials: S
authors.lastname: Nagral
mesh_terms: D002096:C-Peptide / Q000097:blood; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis* / Q000601:surgery*; D007328:Insulin / Q000097:blood; D007340:Insulinoma / Q000175:diagnosis; D007515:Islets of Langerhans / Q000473:pathology; D008875:Middle Aged; D046768:Nesidioblastosis / Q000097:blood / Q000175:diagnosis* / Q000601:surgery*; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000175:diagnosis
chemical_list: D002096:C-Peptide; D007328:Insulin