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Adult onset nesidioblastosis treated by subtotal pancreatectomy
Rahul Amreesh Gupta1, Roma Prahladbhai Patel, Sanjay Nagral
1Department of Surgical Gastroenterology, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India. rahul.g.85@gmail.com
Context:
Nesidioblastosis is a rare cause of non insulinoma pancreatogenous hypoglycemic syndrome seen in adults. It is characterized by postprandial hypoglycemia with high insulin and C-peptide levels without any detectable pancreatic lesion. The definitive diagnosis can be made only on histopathological examination of the resected specimen.
Case Report:
We report a case of a 50-year-old lady presenting with hypoglycemic attacks being misdiagnosed preoperatively as insulinoma and treated with enucleation leading to recurrence of symptoms after 6 months. Later medical therapy was tried which failed and patient needed subtotal pancreatectomy for resolution of symptoms.
Conclusion:
Nesidioblastosis should be suspected in patients with endogenous hyperinsulinemic hypoglycemia without any detectable pancreatic tumor on preoperative imaging.
