utilidad de la ecografía intraoperatoria para la resección de un insulinoma en la cabeza del páncreas usefulness of intraoperative echography for resection of a insulinoma located in the head of pancreas
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2011
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Abstract
El insulinoma es la neoplasia más frecuente entre los tumores neuroendocrinos del páncreas. En el presente trabajo se describe el cuadro clínico, los exámenes de laboratorio e imaginológicos y los aspectos quirúrgicos y complicaciones de una paciente con diagnóstico clínico de insulinoma, sin evidencias por imágenes preoperatorias. La cirugía se indicó sobre la base de las evidencias clínicas y analíticas de hipoglucemia e hiperinsulinemia, y la realización de una laparotomía exploradora donde no se encontró lesión alguna con la palpación directa del páncreas. Se utilizó la ecografía intraoperatoria y se localizó un nódulo de 0,8 cm de diámetro en la cabeza de este órgano. Tras la enucleación se presentó, como complicación posoperatoria, una fístula pancreática de bajo gasto que remitió espontáneamente. El diagnóstico histológico fue de insulinoma benigno. La paciente presentó reversión clínica de los síntomas, además de la normalización de los valores de glucemia, comparados con los preoperatorios.
The insulinoma is the more frequent neoplasms among the neuroendocrine tumors of pancreas. The aim of present paper is to describe the clinical picture, laboratory and imaging examinations and the surgical features as well as the complications in a patient diagnosed with insulinoma without evidences by preoperative images. Surgery was prescribed on the base of clinical and analytic evidences of hypoglycemia and hyperinsulinism and the carrying out of an exploratory laparatomy without any lesion with direct palpation of pancreas. Intraoperative echography was used to locate a 0,8cm nodule in the head of pancreas. After enucleation the only postoperative complication was a low-flow pancreatic fistula with a spontaneous remission. The histological diagnosis was a benign insulinoma. Patient had a clinical reversion of symptoms in addition to normalization of glycemia values, compared to those intraoperative.
The insulinoma is the more frequent neoplasms among the neuroendocrine tumors of pancreas. The aim of present paper is to describe the clinical picture, laboratory and imaging examinations and the surgical features as well as the complications in a patient diagnosed with insulinoma without evidences by preoperative images. Surgery was prescribed on the base of clinical and analytic evidences of hypoglycemia and hyperinsulinism and the carrying out of an exploratory laparatomy without any lesion with direct palpation of pancreas. Intraoperative echography was used to locate a 0,8cm nodule in the head of pancreas. After enucleation the only postoperative complication was a low-flow pancreatic fistula with a spontaneous remission. The histological diagnosis was a benign insulinoma. Patient had a clinical reversion of symptoms in addition to normalization of glycemia values, compared to those intraoperative.
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| Authors | ;Manuel Cepero Valdés;Hanoi Hernández Rivero;Dayana Ugarte Moreno;Lissette Chao González;Manuel Cepero Nogueira;Carlos Ramos Pachón |
| Journal | chemistry and biodiversity |
| Year | 2011 |
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| Keywords | Keywords not found |
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