الفهرس 
Pathology and pathophysiology of insulinomaOnly 14 pages are availabe for public view
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Abstract
Insulinomas, the commonest cause of hypoglycemia related to endogenous hyperinsulinism, occur in 1-4 per million of the population.
Common autonomic symptoms of insulinoma include diaphroresis, tremor, and palpitations, whereas neuroglycopenenic symptoms include confusion, visual disturbances, seizure, and coma, and the diagnosis of insulinoma is based on whipple triad and the 72 h fasting test.
Non-invasive imaging procedures, such as CT and MRI, are used to localize insulinoma, but Invasive modalities, such as EUS and ASVS, are highly accurate in the preoperative localization than non-invasive.
Intraoperative manual palpation of the pancreas by an experienced surgeon and IOUS are highly sensitive for localization of insulinomas.
A high proportion of patients with insulinomas are cured with surgery, also in patients with malignant insulinomas, an aggressive approach, including extended pancreatic resection, liver resection, liver transplantation, chemoembolization, or radiofrequency ablation, is recommended to improve both survival and quality of life.
In patients with unresectable or uncontrollable insulinomas, such as malignant insulinoma of the pancreas, several techniques should be considered, including administration of octereotide and/or continuous glucose monitoring, to prevent hypoglycemic episodes and to improve quality of life.