BYPASS-OMA: Hypoglycemic Hyperinsulinemic Nesidioblastosis after Gastric Bypass Surgery—A Case Report and Review of the Literature

Autor: Jessica Cao, Cindy Kim, Thatcher Huynh, Amanda Frugoli, Heidi Henson, Vera Valdez, Tricia Westhoff-Pankratz
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Case Reports in Endocrinology, Vol 2022 (2022)
Druh dokumentu: article
ISSN: 2090-651X
DOI: 10.1155/2022/5472304
Popis: This rare case vignette describes hypoglycemic, hyperinsulinemic nesidioblastosis in a female patient with prior Roux-en-Y gastric bypass. The patient presented with severe symptomatic hypoglycemia resistant to IV dextrose and diazoxide, requiring surgical resection. Traditional imaging found nonspecific findings, and biochemical analysis was inconsistent with insulinoma. A gallium-68 dotatate PET scan was utilized to successfully localize the tumor in the distal pancreas. She underwent laparoscopic resection of the distal pancreatic lesion with resolution of her symptoms and return to euglycemia. The histological evaluation confirmed the diagnosis of nesidioblastosis. Nesidioblastosis is a rare complication of bariatric surgery that may be more clinically relevant with rising prevalence of obesity. Diagnosis with conventional imaging modalities may be challenging; however, the dotatate PET scan may have high utility in detecting lesions. It is essential for clinicians to consider nesidioblastosis in the differential diagnosis of hyperinsulinemic hypoglycemic conditions and recognize there may be a link with increasing rates of bariatric surgery.
Databáze: Directory of Open Access Journals
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