[Secreting Langerhans adenoma. Difficulties of preoperative lesional diagnosis]

We report the case of a 11-year-old boy suffering from crises of severe hypoglycaemia with high insulin levels. At operation we found a 13 mm adenoma in the head of the pancreas that was enucleated with immediate cure of symptoms. Neither ultrasonography nor CT-scanner (in its conventional and "dynamic" modalities) could help in locating preoperatively the tumor which was nevertheless visible on coeliac axis selective arteriography. The contribution of these new, less invasive, procedures to the diagnosis of pancreatic nodules in children remains to be determined.