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1.
Nicholls AG:  Simple adenomas of the pancreas arising from an island of Langerhans . J Med Res 8:385, 1902.
2.
Banting FG, Best CH:  The internal secretion of the pancreas . J Lab Clin Med 7:251-266, 1921-22.
3.
Wilder RM, Allan FN, Power MH, et al:  Carcinoma of the island of the pancreas—hyperinsulinism and hypoglycemia . JAMA 89:348-355, 1927.Article
4.
Howland G, Campbell WR, Maltby EJ, et al:  Dyinsulinism: convulsions and coma due to islet cell tumor of the pancreas, with operation and cure . JAMA 93:674-679, 1929.Article
5.
Whipple AO, Frantz VK:  Adenoma of the islet cells with hyperinsulinism: a review . Ann Surg 101:1299-1335, 1935.Article
6.
Laroche GP, Ferris DO, Priestly JT, et al:  Hyperinsulinism . Arch Surg 96:763-772, 1968.Article
7.
Williams C Jr, Bryson GH, Hume DM:  Islet cell tumors and hypoglycemia . Ann Surg 169:757-773, 1969.Article
8.
Fajans SS, Conn JW:  An intravenous tolbutamide test as an adjunct in the diagnosis of functioning pancreatic islet cell adenomas, abstracted . J Lab Clin Med 54:811-812, 1959.
9.
Grodsky GM, Forsham PH:  An immunochemical assay of total extractable insulin in man . J Clin Invest 39:1070-1079, 1960.Article
10.
Floyd JC, Fajans SS, Knopf RF, et al:  Plasma insulin in organic hyperinsulinism: comparative effects of tolbutamide, leucine, and glucose . J Clin Endocr 24:747-760, 1964.Article
11.
Johnston R, Goetz FC, Zimmermann B:  Insulin-secreting tumor of the pancreas . New Eng J Med 263:1345-1347, 1960.Article
12.
Scholz DA, ReMine WH, Priestly JT:  Clinics on endocrine and metabolic diseases 3. Hyperinsulinism: Review of 95 cases of functioning pancreatic islet cell tumors . Proc Mayo Clin 35:545-550, 1960.
13.
Olsson O:  Angiographic diagnosis of an islet cell tumor of the pancreas . Acta Chir Scand 126:346-351, 1963.
14.
Rosch J, Bret J:  Arteriography of the pancreas . Amer J Roentgen 94:182-193, 1965.
15.
Baum S, Roy R, Finkelstein AK, et al:  Clinical application of selective celiac and superior mesenteric arteriography . Radiology 84:279-295, 1965.
16.
Bookstein JJ, Oberman HA:  Appraisal of selective angiography in localizing islet-cell tumors of the pancreas . Radiology 86:682-685, 1966.
17.
Epstein HY, Abrams RM, Beranbaum EF, et al:  Angiographic localization of insulinomas: high reported success rate and two additional cases . Ann Surg 169:349-354, 1969.Article
18.
McGarity WC, Miles AE, Hoffman JC:  Angiographic diagnosis and localization of endocrine tumors . Ann Surg 173:583-592, 1971.Article
19.
Thomas RL, Robinson AE, Johnsrude IS, et al:  The demonstration of an insulin and gastrin producing pancreatic tumor by angiography and pancreatic scanning . Amer J Roentgen 104:646-651, 1968.Article
Original Article
January 1972

Insulinoma of the PancreasUse of the Tolbutamide Test, Arteriography, and Selenium Scan in Modern Diagnosis

Author Affiliations

Durham, NC
From the Department of Surgery, Duke University Medical Center, Durham, NC.

Arch Surg. 1972;104(1):56-59. doi:10.1001/archsurg.1972.04180010050013
Abstract

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.

References
1.
Nicholls AG:  Simple adenomas of the pancreas arising from an island of Langerhans . J Med Res 8:385, 1902.
2.
Banting FG, Best CH:  The internal secretion of the pancreas . J Lab Clin Med 7:251-266, 1921-22.
3.
Wilder RM, Allan FN, Power MH, et al:  Carcinoma of the island of the pancreas—hyperinsulinism and hypoglycemia . JAMA 89:348-355, 1927.Article
4.
Howland G, Campbell WR, Maltby EJ, et al:  Dyinsulinism: convulsions and coma due to islet cell tumor of the pancreas, with operation and cure . JAMA 93:674-679, 1929.Article
5.
Whipple AO, Frantz VK:  Adenoma of the islet cells with hyperinsulinism: a review . Ann Surg 101:1299-1335, 1935.Article
6.
Laroche GP, Ferris DO, Priestly JT, et al:  Hyperinsulinism . Arch Surg 96:763-772, 1968.Article
7.
Williams C Jr, Bryson GH, Hume DM:  Islet cell tumors and hypoglycemia . Ann Surg 169:757-773, 1969.Article
8.
Fajans SS, Conn JW:  An intravenous tolbutamide test as an adjunct in the diagnosis of functioning pancreatic islet cell adenomas, abstracted . J Lab Clin Med 54:811-812, 1959.
9.
Grodsky GM, Forsham PH:  An immunochemical assay of total extractable insulin in man . J Clin Invest 39:1070-1079, 1960.Article
10.
Floyd JC, Fajans SS, Knopf RF, et al:  Plasma insulin in organic hyperinsulinism: comparative effects of tolbutamide, leucine, and glucose . J Clin Endocr 24:747-760, 1964.Article
11.
Johnston R, Goetz FC, Zimmermann B:  Insulin-secreting tumor of the pancreas . New Eng J Med 263:1345-1347, 1960.Article
12.
Scholz DA, ReMine WH, Priestly JT:  Clinics on endocrine and metabolic diseases 3. Hyperinsulinism: Review of 95 cases of functioning pancreatic islet cell tumors . Proc Mayo Clin 35:545-550, 1960.
13.
Olsson O:  Angiographic diagnosis of an islet cell tumor of the pancreas . Acta Chir Scand 126:346-351, 1963.
14.
Rosch J, Bret J:  Arteriography of the pancreas . Amer J Roentgen 94:182-193, 1965.
15.
Baum S, Roy R, Finkelstein AK, et al:  Clinical application of selective celiac and superior mesenteric arteriography . Radiology 84:279-295, 1965.
16.
Bookstein JJ, Oberman HA:  Appraisal of selective angiography in localizing islet-cell tumors of the pancreas . Radiology 86:682-685, 1966.
17.
Epstein HY, Abrams RM, Beranbaum EF, et al:  Angiographic localization of insulinomas: high reported success rate and two additional cases . Ann Surg 169:349-354, 1969.Article
18.
McGarity WC, Miles AE, Hoffman JC:  Angiographic diagnosis and localization of endocrine tumors . Ann Surg 173:583-592, 1971.Article
19.
Thomas RL, Robinson AE, Johnsrude IS, et al:  The demonstration of an insulin and gastrin producing pancreatic tumor by angiography and pancreatic scanning . Amer J Roentgen 104:646-651, 1968.Article
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