Clinical features of 52 neonates with XXXX .

@entity1 @entity66 @entity6 @entity660 @entity4053 @entity3190 @entity1412 @entity4854 @entity413
BACKGROUND: Neonatal hyperinsulinemic @entity4053 is often resistant to medical therapy and is often treated with near-total pancreatectomy. However, the @entity660 may be focal and treatable by partial pancreatic resection. METHODS: We studied 52 neonates with @entity3190 who were treated surgically. The type and location of the @entity660 were determined by preoperative pancreatic catheterization and intraoperative histologic studies. Partial pancreatectomy was performed in @entity1 with focal lesions, and near-total pancreatectomy was performed in those with @entity66 . The postoperative outcome was determined by measurements of plasma @entity413 and glycosylated hemoglobin and by oral @entity413 -tolerance tests. RESULTS: Thirty neonates had diffuse beta-cell hyperfunction, and 22 had focal @entity1412 . Among the latter, the lesions were in the head of the pancreas in nine, the isthmus in three, the body in eight, and the tail in two. The clinical manifestations were similar in both groups. The @entity1 with focal lesions had no symptoms of @entity4053 and had normal preprandial and postprandial plasma @entity413 and glycosylated hemoglobin values and normal results on oral @entity413 -tolerance tests after partial pancreatectomy (performed in 19 of 22 neonates). By contrast, after near-total pancreatectomy, 13 of the @entity1 with @entity66 had persistent @entity4053 , @entity6 developed in 8, and @entity4854 developed in another 7; overall, only 2 @entity1 with @entity66 had normal plasma @entity413 concentrations in the first year after surgery. CONCLUSIONS: Among neonates with @entity3190 , about half may have focal islet-cell hyperplasia that can be treated with partial pancreatectomy. These neonates can be identified through pancreatic catheterization and intraoperative histologic studies.
