title: Road accident due to a pancreatic insulinoma: a case report.
abstract: Insulinoma is a rare pancreatic endocrine tumor, typically sporadic and solitary. Although the Whipple triad, consisting of hypoglycemia, neuroglycopenic symptoms, and symptoms relief with glucose administration, is often present, the diagnosis may be challenging when symptoms are less typical. We report a case of road accident due to an episode of loss of consciousness in a patient with pancreatic insulinoma. In the previous months, the patient had occasionally reported nonspecific symptoms. During hospitalization, endocrine examinations were compatible with an insulin-producing tumor. Abdominal computerized tomography and magnetic resonance imaging allowed us to identify and localize the tumor. The patient underwent a robotic distal pancreatectomy with partial omentectomy and splenectomy. Insulin-producing tumors may go undetected for a long period due to nonspecific clinical symptoms, and may cause episodes of loss of consciousness with potentially lethal consequences. Robot-assisted procedures can be performed with the same techniques of the traditional surgery, reducing surgical trauma, intraoperative blood loss, and hospital stays.
authors: From the Unit of Digestive and Liver Surgery (AP, JD, VG, ST, AC), Santa Maria Hospital, Terni; Department of General and Oncologic Surgery (RC, FB, AC, CR, GN), University of Perugia, Perugia; Unit of Internal Medicine (FA, FB, GP, GS), Santa Maria Hospital, Terni; and Department of Medicine (FA, FB, GP, GS), University of Perugia, Perugia, Italy.
authors: Amilcare
authors: A
authors: Parisi
authors: Jacopo
authors: J
authors: Desiderio
authors: Roberto
authors: R
authors: Cirocchi
authors: Veronica
authors: V
authors: Grassi
authors: Stefano
authors: S
authors: Trastulli
authors: Francesco
authors: F
authors: Barberini
authors: Alessia
authors: A
authors: Corsi
authors: Alban
authors: A
authors: Cacurri
authors: Claudio
authors: C
authors: Renzi
authors: Fabio
authors: F
authors: Anastasio
authors: Francesca
authors: F
authors: Battista
authors: Giacomo
authors: G
authors: Pucci
authors: Giuseppe
authors: G
authors: Noya
authors: Giuseppe
authors: G
authors: Schillaci
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D007340:Insulinoma / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D065287:Robotic Surgical Procedures; D014474:Unconsciousness / Q000209:etiology*