Insulinoma is a tumor of the endocrine cells of the islets of the pancreas that produce the hormone insulin. The frequency of this tumor is about 8 cases per million people. Most often it is a benign tumor, about 10% of malignant insulinoma.
Insulinomas occur in children and young patients. In this case, the insulinoma is most often a component of multiple endocrine neoplasia syndrome (MEN), the first type. Typically, insulinomas located in the pancreatic tissue in 99% of cases. 1% are insulinomas, which may occur in the liver, duodenum, stomach, small or large intestine. Benign insulinomas produce insulin alone, malignant, and can produce other hormones and bioactive substances.
Manifestations are due to an increased content of insulinoma insulin in the blood. This gives rise to bouts of hypoglycemia (decrease in the amount of glucose in the blood), accompanied by general weakness, fatigue, sweating, palpitations, anxiety, tension, irritability, anxiety, feelings of hunger. Usually, all these manifestations disappear after a meal.
If a meal for some reason not possible, gradually developed hypoglycemic coma. This state is particularly unfavorable for neurons in the brain that are highly sensitive to the lack of glucose in the blood. Prolonged and frequent hypoglycemic conditions can lead to the development of encephalopathy. By reducing the concentration of glucose initially increased appetite, irritability. A headache. The skin becomes pale and moist. Increased heart rate. Patients in the minds and adequately assess his condition and actions.
Some of the patients do not feel the state of hypoglycemia, which can be dangerous. With a further decrease in the concentration of glucose the patient's behavior is inappropriate. Hallucinations may occur, characterized by vivid paintings. Patients can be aggressive or fun. Sometimes there are attempts to get food, take away someone a meal. There is profuse sweating, salivation, double vision.
With a further increase during hypoglycemia occurs in muscle tone, seizures. There may be a detailed seizure. The pupils dilate, heart rate increases, increased blood pressure, there are neurological signs.
Then comes a hypoglycemic coma with dimming and complete loss of consciousness. Decreased muscle tone, dilated pupils, sweating stops, the blood pressure falls, disrupted breathing, heart rate. There may be a swelling of the brain.
A patient in a state of hypoglycemia in urgent need of medical care. During hypoglycemia, if it lasts a long time can cause myocardial infarction, acute cerebrovascular accident. After an attack of hypoglycemia after a while, especially if the attacks are often a brain lesion that is most vulnerable to starvation and reduce the amount of glucose in the blood. This is a different memory impairment, speech and behavior. You may see a convulsive disorder, Parkinson's disease, circulatory encephalopathy.
Treatment of insulinoma.
In the attack of hypoglycemia in the initial stages of its development needs urgent food intake. The easiest way to give the patient a digestible carbohydrates sweet tea, drink, juice, candy. When violations of consciousness is injected intravenously 40% glucose solution.
Further surgical treatment - removal (enucleation) adenoma of the pancreas or insulin-producing removal of tumors of other origin.
