7 May

Insulinoma of the pancreas - symptoms, treatment

Contents:

1. Symptoms of insulinoma

2. Diagnostics

3. Treatment of insulinoma

4. Forecast treat insulinoma pancreatic

Insulinoma isa rare type of pancreatic tumor that produces insulin and leads to the development of hypoglycemia.

hypoglycemic seizures in this disease are accompanied by a cold sweat, tremor, tachycardia, feeling of fear and hunger, paresthesias, visual, speech and behavioral pathologies, and in severe cases, there may be convulsions and even coma.

Uncontrolled insulin production is accompanied by the formation of the complex and neyroglikopenicheskih adrenergic manifestations - hypoglycemic syndrome.

Typically, pancreatic insulinoma constitute 70-75% of the total amount of hormonally active pancreatic tumors.The disease is much more common in people older age (40-60 years).According to statistics, only 10% of the insulin are malignant.

insulinoma may occur in any part of the pancreas (body, head, tail), very rarely it is placed extrapancreatic, iein the stuff

ing box, the wall of the stomach or the duodenum, the gate of the spleen and liver.Dimensions insulinomas typically range from 1.5 to 2 cm.

Symptoms of insulinoma

In the course of the disease distinguish comparative prosperity phase, which comes to replace the manifestations of hypoglycemia and reactive giperadrenalinemii.As for the latent period, then it only manifestation insulinoma can be increased appetite, and as a consequence - obesity.

insulinoma symptom is acute hypoglycemic attack - the result of failure of adaptation mechanisms of the central nervous system that occurs on an empty stomach, after a long break in the meal, mostly in the morning.At the time of the attack there is a drop in blood glucose content below 2.5 mmol / l.

data insulinoma symptoms often resemble various mental and neurological disorders and manifest themselves in the form of:

  • confusion;
  • headache;
  • ataxia (incoordination);
  • muscle weakness.

Sometimes hypoglycemia attack patients with insulinoma may be accompanied by agitated and have such phenomena as:

  • hallucinations;
  • incoherent cries;
  • restlessness;
  • unmotivated aggression;
  • euphoria.

Simpatico-adrenal system reacts to a sharp hypoglycaemia advent of cold sweat, tremor, tachycardia, anxiety, paresthesias (tingling sensations and numbness).And in the case of an epileptic seizure can occur seizure, loss of consciousness and even coma.As a rule, the attack is interrupted by an intravenous infusion of glucose, but came to himself, the patient does not remember what happened.

During hypoglycemia attack can occur even myocardial infarction due to acute cardiac power.In addition there are signs of such a local damage to the nervous system like hemiplegia and aphasia.A case of chronic hypoglycemia in these patients is disturbed the nervous system (and the central and peripheral), which can affect the course of the comparative prosperity phase.

Symptoms of insulinoma in the interictal period are as follows: myalgia, blurred vision, lethargy, loss of memory and mental abilities.

Even after removing swollen, usually stored encephalopathy and reduced intelligence, resulting in the loss of previous social status and professional skills.Recurrent hypoglycemic episodes can trigger impotence in men.

Symptoms of insulinoma in many respects resemble the symptoms of other diseases, so patients are misdiagnosed, such as a brain tumor, epilepsy, dystonia, stroke, diencephalic syndrome, acute psychosis, neurosis, residual effects neuroinfections and others.

Diagnostics

Identify insulinoma may be difficult.Detection of the tumor by means of functional assays, detection insulin, C-peptide and the blood glucose level.In addition, the US carried out the pancreas, as well as selective angiography.

In order to make the diagnosis of the patient to starve 24 or even 72 hours, with him under surveillance specialists at the hospital.

After fasting symptoms begin to appear, and then carry out blood tests to determine its content of insulin and glucose.Very low blood glucose and high - insulin is an indication of the presence of pancreatic insulinoma.

then need to determine the exact location of the tumor.For these purposes, used computed tomography (CT) and ultrasonography (US).But sometimes these methods are not enough, and recommended conducting a diagnostic operation - laparotomy.

insulin must be differentiated from alcohol and drug hypoglycemia, adrenal and pituitary insufficiency, adrenal cancer, galactosemia and other conditions.

In case of tachycardia episodes, increased blood pressure, sweating, tremors, nausea, weakness, paleness, vomiting and disorientation - to see a doctor.

And in such forms as tachycardia, vascular spasms, sweating, a feeling of anxiety and fear, as well as abuse or loss of consciousness, convulsions and hypoglycemic coma - you should immediately call the emergency medical care.

Treatment of insulinoma

With regard to pancreatic insulinoma in endocrinology preferred surgical approach.The operation is determined by the size and location of the tumor.

insulinoma When surgeons can perform these procedures:

  • insulinomektomiya (enucleation of Education);
  • resection of the pancreas (head resection, distal resection, total pancreatectomy, pancreatoduodenal resection).

surgery Efficacy was assessed by determining the blood glucose level during the operation.

With regard to postoperative complications in the treatment of insulinoma, the suspects include:

  • pancreatitis;
  • pancreatic fistulas;
  • pancreatic necrosis;
  • peritonitis.

there are tumors in which surgery is not used.In these cases, insulin treatment carried out by a conservative.

Doctors usually prescribe giperglikemiziruyuschie agents (epinephrine, norepinephrine, glucagon, glucocorticoids, and others.), Which are aimed at relief and prevention of hypoglycemia.

Malignant insulinoma treatment involves chemotherapy.

Forecast treat insulinoma

pancreatic In most cases (65-80%) after surgery in patients with clinical recovery occurs.Very important is early diagnosis and timely operation.Thanks to them, there is a regression of changes in the central nervous system for EEG data.

Mortality after surgery is 5-10%, and recurrence occurs in approximately 3% of cases.With regard to the prognosis of malignant tumors, it is unfavorable because the survival at 2 years is not more than 60%.

As a rule, patients with a history of insulinoma should be on the dispensary neurologist and an endocrinologist.

Attention!

This article is available exclusively in the educational purposes and is not research material or professional medical advice.

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