Localization of an Insulinoma by Endoscopic Ultrasonography

Chung, Jae Bock; Chun, Sang Bae; Kim, Myung Wook; Lee, Hyun Chul; Kang, Jin Kyung; Park, In Suh; Song, Kun Chang; Shin, Dong Hwan

Abstract

A 45-year-old woman with recurrent disturbances of consciousness for 4 years with hypoglycemia was hospitalized with the clinical suspicion of an insulinoma. The findings of transabdominal ultrasonography, computed tomography and angiography were negative. Transhepatic venous sampling for pancreatic hormone assay showed sudden step-up of serum level of insulin in the venous blood from the tail of the pancreas. Finally, an endoscopic ultrasonographic examination established with certainty the origin of the tumor from the tail of the pancreas, which was subsequently confirmed at operation. In conclusion, endoscopic ultrasonography is a useful and valuable procedure for the localization of insulinoma especially in patient with insulinoma of the pancreas that cannot be localized by conventional methods.