Vig S, Lewis M, Foster K J, Stacey-Clear A
Department of Surgery, East Surrey Hospital, Redhill, Surrey RH1 5RH, England.
J R Soc Promot Health. 2001 Mar;121(1):56-61. doi: 10.1177/146642400112100112.
A 43-year-old man presented with attacks of altered behaviour over a short period of time; they were associated with episodes of hypoglycaemia. The clinical suspicion of insulinoma prompted investigations that quickly established serum insulin and C-peptide levels to be elevated at the times when blood glucose values were low. A physical lesion was found in the head of the pancreas by means of computerised tomography and endo-duodenal ultrasound scan; an octreotide scan was negative. The patient underwent laparotomy and enucleation of a benign tumour, measuring 2.6 cm in diameter, lying within the head of the pancreas; histological examination confirmed it to be an insulinoma. Postoperatively, the patient's personality gradually became more normal and his fasting blood glucose concentrations returned to within normal limits. The diagnosis and management of insulinoma are discussed in the context of this clinical case; there is also reference to the protean clinical manifestations that may occur in this condition- and its differential diagnosis.
一名43岁男性在短时间内出现行为改变发作；这些发作与低血糖发作有关。临床怀疑为胰岛素瘤，促使进行检查，很快确定在血糖值低时血清胰岛素和C肽水平升高。通过计算机断层扫描和十二指肠内超声扫描在胰头部发现一个实体病变；奥曲肽扫描为阴性。患者接受剖腹手术，摘除了位于胰头部的一个直径2.6厘米的良性肿瘤；组织学检查证实为胰岛素瘤。术后，患者的性格逐渐变得更加正常，空腹血糖浓度恢复到正常范围内。结合该临床病例讨论了胰岛素瘤的诊断和治疗；还提及了这种疾病可能出现的多样临床表现及其鉴别诊断。
