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July 1966

Pancreatectomy for Refractory Hypoglycemia in Children

Author Affiliations

From the departments of surgery and pediatrics, Washington University School of Medicine, St. Louis.

Arch Surg. 1966;93(1):40-48. doi:10.1001/archsurg.1966.01330010042006

THE DIFFERENTIAL diagnosis of hypoglycemia in children requires a detailed study of carbohydrate metabolism more commonly than that required in adult hypoglycemia. The indication for surgical or medical therapy depend upon the elucidation of both the cause and the responsiveness of hypoglycemia to therapy as well as the determination of the likelihood of tumor-induced hypoglycemia.

This study was devised to evaluate the diagnostic methods used to select those children requiring subtotal pancreatectomy to control recurrent and refractory hypoglycemia. The data collected from investigation of carbohydrate metabolic abnormalities is described with a view toward separating islet-cell tumors of the pancreas, hyperplasia of islet-cell tissue, and primary idiopathic hypoglycemia of childhood including leucine sensitivity.

Fifteen children with severe recurrent hypoglycemia were evaluated and six had subtotal pancreatic resection as therapy. There were no deaths in the group treated by surgery. The classification of hypoglycemia in infants and children used as a basis