[Therapeutic and diagnostic problems in a patient with insulinoma (author's transl)]

Surgical intervention in organic hyperinsulinism is based on prior accurate biochemical assessment. The emergent problems are discussed in a case with hypoglycaemic attacks, where "blind" pancreatic resections had been performed in two occasions without success. Finally, after demonstration of hyperinsulinaemia and localization of the tumour by selective angiography an adenoma was removed surgically. The postoperative complications, including the development of insulin-dependent diabetes, demonstrate the inherent risks of blind distal pancreatectomy for suspected insulinoma.