A Clinical Case of Insulinoma Presenting with Postprandial Hypoglycemia in a Patient with a History of Gastric Bypass Surgery.
A 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.
['Hayashida|Ryosuke|R|', 'Tsuchiya|Kyoichiro|K|', 'Sekine|Tetsuo|T|', 'Momose|Takashi|T|', 'Sato|Fuminori|F|', 'Sakurada|Maya|M|', 'Nishida|Kenji|K|', 'Hayashi|Tatsuya|T|', 'Morita|Yasuhiro|Y|', 'Okada|Haruka|H|', 'Fukushima|Noriyoshi|N|', 'Yamada|Tetsuya|T|', 'Tsujino|Motoyoshi|M|']
insulinoma hypoglycemia