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Hiperinsulinemia después de una extensa resección del intestino delgado y nutrición parenteral total en un recién

Maisam Raqi Tobeh¹, Bashir Hamad Elnaem¹, Dafalla Ahmed Rahmatalla¹

¹Al Qassimi Women's and Children Hospital, Sharjah, United Arab Emirates.

Nutrition and metabolic insights

|February 9, 2026

Resumen

La hiperinsulinemia neonatal, una causa rara de hipoglucemia persistente en los recién nacidos, puede conducir a problemas de desarrollo neurológico. El diagnóstico y el tratamiento tempranos son cruciales, especialmente en los bebés con síndrome de intestino corto que requieren nutrición parenteral total.

Área de la Ciencia:

Neonatología Neonatología.
Endocrinología Pediátrica Endocrinología pediátrica.
Gastroenterología Quirúrgica Gastroenterología Quirúrgica

Sus antecedentes:

La hiperinsulinemia neonatal aumenta el riesgo de hipoglucemia recurrente y complicaciones del desarrollo neurológico.
Puede ser congénita, inducida por el estrés o secundaria a intervenciones como la nutrición parenteral total (PNT).
Los bebés con síndrome de intestino corto (SBS) después de la resección intestinal enfrentan mayores riesgos.

Objetivo del estudio:

Para presentar un caso de hiperinsulinemia inducida por el estrés en un neonato con síndrome de intestino corto.
Para resaltar los desafíos de diagnóstico y gestión en esta compleja población de pacientes.
Hacer hincapié en la importancia de la identificación temprana y la atención multidisciplinaria.

Principales métodos:

Un informe de caso de un neonato de 2 semanas de edad con ictericia, emesis y poco aumento de peso.
La intervención quirúrgica para el volvulus del intestino medio condujo a una extensa resección del intestino delgado y al síndrome del intestino corto.
El manejo implicó la optimización de la TPN, el monitoreo de la glucosa y la farmacoterapia (diazóxido, hidroclorotiazida).

Principales resultados:

El recién nacido experimentó hipoglucemia persistente a pesar de las infusiones de glucosa en dosis altas.
Los hallazgos de laboratorio indicaron niveles elevados de insulina con otras hormonas normales, lo que sugiere hiperinsulinemia inducida por el estrés.
La farmacoterapia estabilizó la glucosa en sangre, permitiendo la transición a la alimentación enteral parcial.

Conclusiones:

El diagnóstico y el manejo de la hiperinsulinemia en neonatos dependientes de TPN con SBS es complejo.
La hipoglucemia persistente a pesar de la glucosa alta justifica la sospecha de hiperinsulinismo.
El manejo temprano y multidisciplinario es vital para prevenir complicaciones graves.

Palabras clave:

La terapia con diazoxido es una terapia de diazoxido.La hipoglucemia es una hipoglucemia.En el intestino medio se encuentra el volvulus volvulus.La hiperinsulinemia neonatal es una hiperinsulinemia neonatal.síndrome del intestino corto (SBS, por sus siglas en inglés)nutrición parenteral total (TPN, por sus siglas en inglés)

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