[Pancreatic resection in the treatment of infantile hypoglycaemia]

Authors report four patients with hyperinsulinemic unremitting hypoglycaemia due to pancreatic nesidioblastosis. Onset was neonatal in three of them and at the end of the first year in the remaining one. After variable periods of only partially successful medical therapy, the four patients were operated and subtotal pancreatectomy was carried out. This alone was sufficient in one case, and in another one diazoxide made control possible. The other two children had a total pancreatectomy, and one of them has needed insulin ever since. Hypoglycaemia is under control in all children and only one has mental impairment. Diagnostic work-up and surgical techniques are described, and the need for a prompt operation when medical control is incomplete is stressed. Although apparently a blind and major undertaking, surgery is still the only way of preserving neuronal function in some selected cases.