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Insulinoma after sleeve gastrectomy: A case report
Miry Lobaton-Ginsberg1, Pilar Sotelo-González2, Claudia Ramirez-Renteria3
1Facultad de Medicina, Universidad Anáhuac México Norte, Mexico City 52786, Mexico.
World Journal of Clinical Cases
|August 11, 2022
Summary
A rare case of insulinoma, a pancreatic tumor causing hypoglycemia, was diagnosed after laparoscopic sleeve gastrectomy (LSG). Surgical removal resolved the symptoms, highlighting the need for awareness of this complication post-obesity surgery.
Area of Science:
- Endocrinology
- Bariatric Surgery
- Oncology
Background:
- Laparoscopic sleeve gastrectomy (LSG) is increasingly used for obesity and metabolic disorders.
- Post-bariatric surgery hypoglycemia can occur, with insulinoma being a rare cause.
- No prior reports linked insulinoma to LSG.
Observation:
- A 43-year-old woman presented with fasting hypoglycemia 2 years post-LSG.
- Symptoms met Whipple's triad criteria, initially suggesting dumping syndrome.
- A 72-hour fast test confirmed hyperinsulinemic hypoglycemia.
Findings:
- Imaging revealed a pancreatic tumoral lesion consistent with insulinoma.
- Laparoscopic enucleation successfully removed the insulinoma.
- Histopathology confirmed a well-differentiated grade 2 neuroendocrine tumor.
Implications:
- Insulinoma is a rare but possible complication following LSG.
- Clinicians should consider insulinoma in LSG patients with fasting hypoglycemic symptoms.
- Early diagnosis and surgical intervention can resolve symptoms effectively.
