A Clinical Case of Insulinoma Presenting with Postprandial Hypoglycemia in a Patient with a History of Gastric Bypass Surgery

Intern Med. 2021 Oct 12. doi: 10.2169/internalmedicine.7428-21. Online ahead of print.ABSTRACTA 61-year-old man with a history of total gastrectomy for cancer with Roux-en-Y reconstruction showed severe postprandial hypoglycemia accompanied by endogenous hyperinsulinemia. Abdominal ultrasonography and contrast-enhanced computed tomography showed no abnormal findings in the pancreas. A selective arterial secretagogue injection test showed the marked induction of serum immunoreactive insulin when calcium was injected into the splenic artery. A pathological analysis following distal pancreatectomy with splenectomy revealed a pancreatic neuroendocrine microadenoma containing insulin-producing cells in the resected pancreas. This case highlights the importance of carefully evaluating refractory and severe hypoglycemia in patients with a history of gastric surgery to exclude insulinoma.PMID:34645754 | DOI:10.2169/internalmedicine.7428-21

Source: Internal Medicine - October 14, 2021 Category: Internal Medicine Authors: Ryosuke Hayashida Kyoichiro Tsuchiya Tetsuo Sekine Takashi Momose Fuminori Sato Maya Sakurada Kenji Nishida Tatsuya Hayashi Yasuhiro Morita Haruka Okada Noriyoshi Fukushima Tetsuya Yamada Motoyoshi Tsujino Source Type: research