胰腺胰岛素瘤的内镜超声波导向的射频移除
Kidmealem Zekarias1, Mohammad Alutaibi2, Jimmie Stewart2
1Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA kzekaria@umn.edu.
BMJ case reports
|January 27, 2026
概括
一名患有严重低血糖症和精神状态改变的患者被诊断为内源性高胰岛素症. 内镜超声波 (EUS) 确定了一种胰腺神经内分泌瘤,并通过EUS引导的射频剥离 (EUS引导的RFA) 成功治疗.
科学领域:
- 内分泌学 在内分泌学.
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
背景情况:
- 一名中年男性在发生机动车祸后出现精神状态变化和严重低血糖症.
- 症状包括,出汗,难以集中注意力,持续进食,体重增加和低血糖不知觉.
研究的目的:
- 为了诊断内源性高胰岛素的原因,在一个负面常规成像的患者.
- 评估内镜超声波导向射频剥离 (EUS导向RFA) 治疗胰腺神经内分泌瘤的疗效.
主要方法:
- 一个72小时监督的快速证实了内源性高胰岛素症,胰岛素和C-水平升高.
- 内镜超声波 (EUS) 和活检确定了一种13毫米的胰腺头部神经内分泌瘤.
- 进行了EUS引导的射频除 (EUS引导的RFA) 治疗.
主要成果:
- 在监督禁食期间证实了内源性高胰岛素.
- 传统的成像 (CT,DOTATATE-PET) 无法识别瘤.
- EUS成功地发现了胰腺头部瘤,导致了成功的EUS引导的RFA.
- 患者经历了立即的症状缓解和正常的术后生化特征.
结论:
- 在常规成像检测呈阴性结果时,EUS是诊断胰腺病变的宝贵工具.
- EUS引导的RFA是一种有效的治疗胰腺神经内分泌瘤,导致高胰岛素.
- 这一案例突出了成功的最小侵入性方法来管理低血糖症的罕见原因.
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