Insulinoma: Report of two cases in the general surgery service in Hospital Carlos Andrade Marin

There is a variety of endocrine tumours of the pancreas capable of producing hyperinsulinism and neuroendocrinologic symptoms due to hypoglycaemia. Initially they are treated as neurologic or psychiatric disorders and can take years to establish a definitive diagnosis. We present two cases of patients admitted to the service of General Surgery department of the Carlos Andrade Marin Hospital in the years 1999 and 2000. These patients were transferred from the endocrinology department l. The clinical diagnosis was based on monitoring of glycemic and insulin base levels and were complemented with CAT scan and MRI. Surgical procedures were performed obtaining satisfactory enucleating of the tumours. They were localized in the body and the tail of the pancreas respectively. We evidenced immediate normalization of the glycemia during and post operatively. The most important complication in the first case was pancreatic abscess that was drained in an open manner surgically, afterwards a pancreatic leak was determined, and it so was successfully treated with octreotide, the second patient presented a pulmonary atelectacy in the first 24 hours after the post operatory and a week later the presence of a sufrenic abscess on the right side was quite evident, which was treated through percutaneous draining guided by computerized tomography and magnetic resonance. (The author)