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A Surgical Dilemma

Jay K. Harness, MD; Glenn W. Geelhoed, MD; Norman W. Thompson, MD; Ronald H. Nishiyama, MD; Stefan S. Fajans, MD; Richard O. Kraft, MD; Donald R. Howard, MD; Kenneth A. Clark, MD

Arch Surg. 1981;116(5):575-580.

Abstract
• 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.

(Arch Surg 1981;116:575-580)

Author Affiliations
From the Departments of Surgery (Drs Harness and Thompson), Pathology (Dr Clark), and Internal Medicine, Division of Endocrinology and Metabolism (Dr Fajans), University of Michigan, Ann Arbor; Department of Surgery (Dr Geelhoed), George Washington University Medical Center, Washington, DC; Department of Surgery (Dr Kraft), St Joseph's Mercy Hospital, Ann Arbor; and Department of Pathology (Drs Nishiyama and Howard), Maine Medical Center, Portland.

Footnotes
Accepted for publication Dec 12, 1980.

Read before the 88th annual meeting of the Western Surgical Association, Salt Lake City, Nov 17, 1980.

Reprint requests to Department of Surgery, B4963 CFOB, University of Michigan Medical Center, Ann Arbor, MI 48109 (Dr Harness).

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