Because the syndrome of hyperinsulinism secondary to disease of the pancreas or the biliary and gastrointestinal tract is little known in this country, a nationwide review of the clinicopathologic material of the Veterans Administration was carried out. Nine of 10 patients with hyperinsulinism showed pathological findings in the exocrine pancreas or the organs adjacent to it. Similar pathological findings were present in 9 of 11 patients with hyperplasia of the islands but without hyperinsulinism and in 4 of 10 patients with islet cell adenoma without hyperinsulinism. It is proposed that these pathological changes of the exocrine pancreas or adjacent organs, by abnormal stimulation of the vegetative nerve fibers in the pancreatic or parapancreatic region, cause hyperinsulinism or hyperplasia and adenomata of the islands of Langerhans or both.
Friedlander EO. Hyperinsulinism in Pancreatic or Biliary and Gastrointestinal Tract DiseaseA Clinicopathologic Survey Among Veterans Administration Hospital Patients. JAMA. 1961;177(5):300–303. doi:10.1001/jama.1961.03040310018005
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