Diagnosis and management of insulinoma

摘要: Insulinomas, the most common cause of hypoglycemia related to endogenous hyperinsulinism, occur in 1-4 people per million general population. Common autonomic symptoms insulinoma include diaphroresis, tremor, and palpitations, whereas neuroglycopenenic confusion, behavioural changes, personality visual disturbances, seizure, coma. Diagnosis suspected cases is based on standard endocrine tests, especially prolonged fasting test. Non-invasive imaging procedures, such as computed tomography magnetic resonance imaging, are used when a diagnosis has been made localize source pathological insulin secretion. Invasive modalities, endoscopic ultrasonography arterial stimulation venous sampling, highly accurate preoperative localization insulinomas have frequently shown be superior non-invasive techniques. The range techniques available for means that blind resection can avoided. Intraoperative manual palpation pancreas by an experienced surgeon intraoperative both sensitive methods with which finalize location insulinomas. A high proportion patients cured surgery. In malignant insulinomas, aggressive medical approach, including extended pancreatic resection, liver transplantation, chemoembolization, or radiofrequency ablation, recommended improve survival quality life. unresectable uncontrollable pancreas, several should considered, administration ocreotide and/or continuous glucose monitoring, prevent hypoglycemic episodes