Contrast-Enhanced Endoscopic Ultrasonography Improves the Preoperative Localization of Insulinomas
| Autor: | Yoshihisa Suminaga, Hiroyuki Tamemoto, Michio Imawari, Aki Ikoma, Takafumi Hyodo, Yasuko Sugiura, Keizo Kasono, San-e Ishikawa, Kazuyuki Namai, Masanobu Kawakami |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Fasting Hypoglycemia Endocrinology Diabetes and Metabolism Enucleation Contrast Media Endoscopic ultrasonography Endosonography Gastroduodenal artery Endocrinology medicine.artery medicine Humans Insulinoma Aged Pancreatic duct High concentration business.industry Angiography medicine.disease digestive system diseases Pancreatic Neoplasms Intraductal ultrasonography medicine.anatomical_structure Female Radiology Tomography X-Ray Computed business |
| Zdroj: | Endocrine Journal. 49:517-522 |
| ISSN: | 1348-4540 0918-8959 |
| DOI: | 10.1507/endocrj.49.517 |
| Popis: | We report a case in which endoscopic ultrasonography (EUS), intraductal ultrasonography (IDUS) and contrast-enhanced EUS using Levovist helped to localize insulinoma correctly. A 74-year-old woman complained of symptomatic fasting hypoglycemia with relatively high concentration of serum insulin level. Dynamic contrast-enhanced computed tomography revealed a small tumor of 8 mm diameter in the pancreatic head. Insulin secretion was strongly stimulated by calcium injection into the gastroduodenal artery. To clarify the precise localization, we performed EUS, IDUS and contrast-enhanced EUS. The tumor was enhanced clearly by Levovist, and the distance from the main pancreatic duct was more than 3 mm. Therefore, a preoperative decision could be made to use the enucleation method for resection of the tumor. The surgeon could enucleate the tumor in a brief operation according to the preoperative diagnosis, and serum glucose levels returned to normal range after the operation. Contrast-enhanced EUS using Levovist was shown to be a useful diagnostic method for precise localization of small insulinoma. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|