Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2007-5-11
pubmed:abstractText
A 40-year-old woman with recurrent episodes of hypoglycemia was referred because of suspected insulinoma. Prolonged fasting was discontinued after 24 h due to symptomatic hypoglycemia (29 mg/dl, glucose/insulin-ratio 0.34). Magnetic resonance tomography showed a small 0.3 cm lesion in the body of the pancreas. During subsequent surgery a pancreatic tumor could not be detected, neither by manual palpation nor intraoperative ultrasonography. A hyperinsulinemic, sequentially eu- and hypoglycemic clamp confirmed the biochemical diagnosis of endogenous hyperinsulinemia and intra-arterial calcium stimulation localized calcium responsive tissue in the feeding distribution of the superior mesenteric artery. An octreotide scan was negative. During relaparotomy, six weeks after the initial surgery, the pancreatic body and tail were resected and a approximately 1 cm non-malignant insulinoma was found. Although the use of highly sensitive, and more sophisticated and expensive methods for the diagnosis and localization of insulinomas are not generally suggested, we recommend application of intra-arterial calcium stimulation if the tumor is not detected using conventional diagnostic procedures.
pubmed:commentsCorrections
http://linkedlifedata.com/resource/pubmed/commentcorrection/17491664-11095416, http://linkedlifedata.com/resource/pubmed/commentcorrection/17491664-11114622, http://linkedlifedata.com/resource/pubmed/commentcorrection/17491664-11748487, http://linkedlifedata.com/resource/pubmed/commentcorrection/17491664-14564685, http://linkedlifedata.com/resource/pubmed/commentcorrection/17491664-1745987, http://linkedlifedata.com/resource/pubmed/commentcorrection/17491664-2170840, http://linkedlifedata.com/resource/pubmed/commentcorrection/17491664-2241318, http://linkedlifedata.com/resource/pubmed/commentcorrection/17491664-2839328, http://linkedlifedata.com/resource/pubmed/commentcorrection/17491664-7611592, http://linkedlifedata.com/resource/pubmed/commentcorrection/17491664-7611598, http://linkedlifedata.com/resource/pubmed/commentcorrection/17491664-7700289, http://linkedlifedata.com/resource/pubmed/commentcorrection/17491664-9061303, http://linkedlifedata.com/resource/pubmed/commentcorrection/17491664-9426439
pubmed:language
eng
pubmed:journal
pubmed:status
PubMed-not-MEDLINE
pubmed:issn
1614-0575
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
1
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
42-6
pubmed:dateRevised
2009-11-18
pubmed:year
2004
pubmed:articleTitle
Diagnosis and localization of insulinoma after negative laparotomy by hyperinsulinemic, hypoglycemic clamp and intra-arterial calcium stimulation.
pubmed:affiliation
Department of Medicine I, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. robert.ritzel@med.uni-heidelberg.de
pubmed:publicationType
Journal Article