Adult-Onset Nesidioblastosis, A Diagnostic and Management Dilemma

Author(s): Pankaj Baweja

We describe a case of a 49-year-old female patient with recurrent postprandial symptomatic hypoglycemia. The hypoglycemia was combined with increased insulin and C peptide but all diagnostic modalities for localizing an insulinoma were negative. Medical management didn't control symptoms and thus the patient underwent subtotal distal pancreatectomy. Surgical tissue audit confirmed the diagnosis of noninsulinoma pancreatogenous hypoglycaemia syndrome (NIPHS) or nesidioblastosis.  

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