Abstract

LOPEZ, Vanessa et al. Nesidioblastosis in the adult following gastric bypass. rev. colomb. cir. [online]. 2017, vol.32, n.4, pp.319-329. ISSN 2011-7582.  https://doi.org/10.30944/20117582.40.

Hypoglycemia due to endogenous hyperinsulinism has been described as a complication of bariatric surgery. We present the case of a 34-year-old man who developed a Whipple's triad eight years after undergoing gastric bypass. Hypoglycemia was associated with high serum levels of insulin and C peptide; anatomic localization of endogenous hyperinsulinism was finally demonstrated with a selective intra-arterial calcium-stimulation test. Patient was offered a laparoscopic subtotal pancreatectomy, which resulted in an excellent postoperative course and significant symptoms resolution. Pathology report and inmunohistochemical analysis confirmed the diagnosis of adult nesidioblastosis. We believe it is important to recognize this condition as a complication of bariatric surgery, a procedure performed more frequently nowadays due to the obesity epidemic. Symptoms might be confused with those of dumping syndrome which does not have severe consequences in the patient's health as nesidioblastosis does.

Keywords : Nesidioblastosis; gastric bypass; postoperative complications; dumping syndrome; hypoglycemia; hyperinsulinism.

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