Valoración de la utilidad del test de estimulación intraarterial con calcio en el diagnóstico de localización del hiperinsulinismo endógeno

Moreno-Moreno, Paloma; Alcántara, Carmen Gutiérrez; Muñoz-Villanueva, María del Carmen; Ortega, Rafael; Jimenez, M.L.; Tendero, Luis Zurera; López, Pedro Benito

doi:10.1016/j.endonu.2010.01.007

Cited by 6 publications

(6 citation statements)

References 14 publications

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“…Previous studies have reported that conventional location techniques mainly detected tumors larger than 2 cm; intraoperative US and multislice CT progressively demonstrate increased sensitivity to detect the existence of an insulinoma [ 2 , 5 , 13 , 23 ]. The EUS is the procedure of choice recommended for some authors [ 23 ]; it allows diagnosis of 84–100% tumors located in the head or body of the pancreas, but this technique has a decreased sensitivity in lesions located in the tail of pancreas (60%) [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Hypoglycemia is manifested by the appearance of Whipple's triad: hypoglycemia (plasma glucose < 50 mg/dL), neuroglycopenic symptoms, and prompt relief of symptoms following the administration of glucose. The most common causes of hypoglycemia in nondiabetic healthy adults are factitious hypoglycemia and endogenous hyperinsulinism [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Erroneous preoperative localization of insulinoma is estimated at 75% of cases depending on the diagnosis method [ 7 ]. Preoperative localization methods include transabdominal ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI) [ 8 ], endoscopic ultrasonography (EUS) [ 9 , 10 ], and intra-arterial calcium stimulation test with hepatic venous sampling (ASVS) [ 2 , 5 , 11 ]. Noninvasive techniques globally allow the localization of less than 80% of insulinomas.…”

Section: Introductionmentioning

confidence: 99%

“…The selective venous sampling after percutaneous transhepatic puncture is an invasive technique with greater sensitivity (75–100%) and specificity (94–100%) [ 2 , 15 ]. Doppman et al [ 16 , 17 ] introduced ASVS as an alternative method with similar results and less morbidity.…”

Section: Introductionmentioning

confidence: 99%

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Arterial Calcium Stimulation with Hepatic Venous Sampling in the Localization Diagnosis of Endogenous Hyperinsulinism

Moreno-Moreno

Alhambra-Expósito

Herrera‐Martínez

et al. 2016

International Journal of Endocrinology

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Objective. The aim of this study was to assess the utility of arterial calcium stimulation with hepatic venous sampling (ASVS) in the localization diagnosis of endogenous hyperinsulinism. Patients and Methods. A retrospective descriptive study was performed including patients with endogenous hyperinsulinism who underwent ASVS. The histopathological diagnosis in patients who underwent a surgical procedure was used as the reference for the statistical study of the accuracy of this technique. Results. 30 patients were included with endogenous hyperinsulinism and nonconclusive imaging diagnosis was included. ASVS was performed in all cases. Surgery was performed in 20 cases. Insulinoma was removed in 19 patients; the location of all cases was detected in the ASVS. All cases of endogenous hyperinsulinism had a positive result for the ASVS, with this association being statistically significant (χ 2 = 15.771; p < 0.001). A good and statistically significant agreement was obtained between histopathologic diagnosis and ASVS results (K = 0.518, p < 0.001). Conclusions. ASVS is a useful procedure in the localization diagnosis of endogenous hyperinsulinism undetected by other imaging tests. This technique allows the localization of intrapancreatic insulinomas and represents useful tool for the diagnosis and surgical management of these tumors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Arterial Calcium Stimulation with Hepatic Venous Sampling in the Localization Diagnosis of Endogenous Hyperinsulinism

Moreno-Moreno

Alhambra-Expósito

Herrera‐Martínez

et al. 2016

International Journal of Endocrinology

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“…[23] Recently, different study groups recommended this ASVS test as superior to other localising tools. [2024]…”

Section: Localisationmentioning

confidence: 99%

Insulinoma and anaesthetic implications

2012

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Insulinoma is a rare neuroendocrine tumour of the pancreas , which is usually small, solitary and benign. It may be part of the multiple endocrine neoplasia type 1 syndrome. It is diagnosed by clinical, biochemical and imaging modalities. Hypoglycaemic symptoms can be medically controlled by diazoxide or somatostatin analogues. Localisation of the tumour is a challenge to clinicians. Surgical resection is the curative treatment with a high success rate. Intraoperatively, ultrasound and surgical palpation help to confirm the site of tumour. Intraoperatively, maintenance of optimum glucose levels is of main concern because there may be severe hypoglycemia while handling the tumour, symptoms of which remain masked under general anaesthesia. Glucose infusion and frequent plasma glucose monitoring to maintain plasma glucose level more than 60 mg/dL is found to be helpful. We performed a systematic search in PubMed, Cochrane Library and also in Google. We used the following text words for our search: Insulinoma, neuro-endocrine tumors, multiple endocrine neoplasia, hypoglycemia, anaesthetic management of insulinoma, glucose management. In this article, we review the incidence and epidemiology of insulinoma, its clinical features, diagnosis, localisation and treatment, with special emphasis on anaesthetic management.

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An Interventionist’s Guide to Endocrine Consultations

et al. 2017

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Endocrinopathies are a heterogeneous group of disorders often resulting from pathologic sources of hormone production. When the clinical scenario, laboratory testing, and noninvasive imaging fail to aid confident identification of the source of hormone excess, endocrine venous sampling may localize obscure lesions to guide subsequent treatment. Knowledge of basic hormone signaling pathways, common pathophysiologic disruptions of these pathways, and serologic evaluation fosters informed conversations with referring physicians and effective patient selection. Success in the angiography suite requires familiarity with normal and variant anatomy of the multiple organs of the endocrine system, patient preparation, stimulation and sampling techniques, specimen handling, and results interpretation. RSNA, 2017.

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Valoración de la utilidad del test de estimulación intraarterial con calcio en el diagnóstico de localización del hiperinsulinismo endógeno

Cited by 6 publications

References 14 publications

Arterial Calcium Stimulation with Hepatic Venous Sampling in the Localization Diagnosis of Endogenous Hyperinsulinism

Arterial Calcium Stimulation with Hepatic Venous Sampling in the Localization Diagnosis of Endogenous Hyperinsulinism

Insulinoma and anaesthetic implications

An Interventionist’s Guide to Endocrine Consultations

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