Nesidioblastosis in adults. A surgical dilemma
J. K. Harness, G. W. Geelhoed, N. W. Thompson, R. H. Nishiyama, S. S. Fajans, R. O. Kraft, D. R. Howard and K. A. Clark
Nesidioblastosis is the leading cause of hyperinsulinemia in newborns and
infants. To our knowledge, it has not been previously reported in adults
unless associated with other diseases. Three males and three females, aged
11 to 57 years, are described. Pancreatic resections ranged from 50% to
100%. Postoperatively, three patients were normoglycemic, two were
insulin-dependent diabetics, and one had recurrent hypoglycemia controlled
by drugs. The histologic findings in adults were very similar to those in
infants with nesidioblastosis. It appears that a minimum resection of 75%
to 80% of the pancreas will benefit the majority of patients, alleviating
hypoglycemia and preventing the development of diabetes.
