Case ReportInsulinoma-Induced Hypoglycemia in a Patient With Nesidiodysplasia After Vagomotomy and Pyloroplasty for Duodenal Ulcer
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CASE REPORT
A 45-year-old woman was referred to us for symptomatic hypoglycemia (capillary blood glucose of 25 and 30 mg/dL). She underwent troncular vagotomy and pyloroplasty for duodenal ulcer 20 years ago. After surgery, she developed a dumping syndrome with tachycardia, palpitations, feeling nausea, diarrhea, dizziness, trembling, and hyperhidrosis, approximately 15 to 20 minutes after meals lasting 60 to 90 minutes. Two months before her initial visit, the patient began with episodes of sweating, tremor,
DISCUSSION
To the best of our knowledge, this is the first report of a patient with insulinoma-induced hypoglycemia associated with nesidiodysplasia after vagotomy and pyloroplasty for peptic ulcer. This disorder was manifested both by fasting hypoglycemia and by postprandial hyperinsulinemic hypoglycemia (insulin ≥3 μU/mL and C-peptide ≥0.6 ng/mL with concomitant glucose level <55 mg/dL and the absence of sulfonylureas in serum).1
The relationship between the development of endogenous hyperinsulinemic
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