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Surgical Management of Hyperinsulinemic Hypoglycemia in Children
Patricia S. Simmons, MD;
Robert L. Telander, MD;
J. Aidan Carney, MD, PhD;
Lester E. Wold, MD;
Morey W. Haymond, MD
Arch Surg. 1984;119(5):520-525.
Abstract
• Nineteen children underwent subtotal pancreatectomy for hyperinsulinemic hypoglycemia. Of the four who were older than 10 years of age at onset of symptoms, three had islet adenomas, and one had endocrine cell dysplasia (ECD). The two patients with multiple adenomas had a family history of multiple endocrine neoplasia, type 1 (MEN 1). Of the 15 who were younger than 1 year of age at onset of symptoms, 12 had ECD alone, and three had ECD with adenomatosis. Four children required a second surgical procedure and near-total pancreatectomy because of persistent hypoglycemia. All 19 patients' conditions improved, with no postsurgical complications. After near-total pancreatectomy, all four patients were treated for fat malabsorption, but only two required insulin because of secondary diabetes mellitus. We concluded that subtotal pancreatectomy is a safe, effective adjunct to the treatment of children with hyperinsulinemic hypoglycemia.
(Arch Surg 1984;119:520-525)
Author Affiliations
From the Departments of Pediatrics (Drs Simmons and Haymond) and Pathology (Drs Carney and Wold) and the Section of Pediatric Surgery (Dr Telander), Mayo Clinic and Mayo Foundation, Rochester, Minn.
Footnotes
Accepted for publication Jan 9, 1984.
Read before the 91st annual meeting of the Western Surgical Association, Monterey, Calif, Nov 14, 1983.
Reprint requests to Mayo Clinic, 200 First St SW, Rochester, MN 55905 (Dr Telander).
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