Hyperinsulinism, secondary to islet cell tumors of the pancreas, is a relatively uncommon but serious disorder. In the past, it has been difficult to diagnose, identify, and remove the tumor. Insulin-secreting tumors of the pancreas occurred in 12 of our patients. Current endocrinologic and radiological methods allow the establishment of a diagnosis and localization of islet cell tumors with assurance. Patients with symptoms suggesting hyperinsulinism should undergo fasting blood glucose and tolbutamide tolerance tests. If these studies suggest the presence of a hypersecreting tumor of the pancreas, a celiac arteriogram may accurately localize the tumor (or tumors) so that "blind" resection of the pancreas will be unnecessary.
Wolfe WG, Mullen DC, Silver D. Insulinoma of the PancreasUse of the Tolbutamide Test, Arteriography, and Selenium Scan in Modern Diagnosis. Arch Surg. 1972;104(1):56-59. doi:10.1001/archsurg.1972.04180010050013