title: Adult-onset diffuse nesidioblastosis causing hypoglycemia.
abstract: We report the case of a 32-year-old male with adult-onset diffuse nesidioblastosis causing hypoglycemia. Under the tentative diagnosis of insulinoma, localization procedures were carried out but no tumor was found. The presence of an insulinoma in the tail of the pancreas was suggested by selective intra-arterial calcium stimulation with hepatic venous sampling (ASVS). A distal pancreatectomy was performed under the assumed diagnosis of insulinoma in the tail based upon the ASVS. Diffuse nesidioblastosis was diagnosed by histopathological evaluation. During the post-operative course, the patient's glucose and insulin levels were well controlled and uneventful without any medications or insulin for 7 months.
authors.affiliation: Department of Gastroenterology, Nikko Memorial Hospital, Muroran, Japan. yasuharumaeda610@hotmail.com.|Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohoma, Japan. yasuharumaeda610@hotmail.com.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Maeda
authors.affiliation: Department of Gastroenterology, Nikko Memorial Hospital, Muroran, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yokoyama
authors.affiliation: Department of Gastroenterology, Nikko Memorial Hospital, Muroran, Japan.|Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohoma, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Takeda
authors.affiliation: Department of Surgery, Nikko Memorial Hospital, Muroran, Japan.
authors.forename: Jyouji
authors.initials: J
authors.lastname: Takada
authors.affiliation: Department of Surgery, Nikko Memorial Hospital, Muroran, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Hamada
authors.affiliation: Department of Pathology, Nikko Memorial Hospital, Muroran, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Hujioka
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohoma, Japan.
authors.forename: Shin-Ei
authors.initials: SE
authors.lastname: Kudo
keywords: ASVS; Hypoglycemia; Nesidioblastosis