Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with classic Whippleโs triad: (1) symptoms of hypoglycemia (diaphoresis, palpitations, tremors, confusion), (2) documented low plasma glucose levels, and (3) relief of symptoms following glucose administration. Symptoms are episodic, often occurring during fasting or post-exercise. No history of exogenous insulin or sulfonylurea use.
Clinical Examination Findings
General appearance: Alert and oriented, no acute distress. Vitals stable. Abdominal exam: Soft, non-tender, non-distended. No palpable masses or organomegaly. Neurological exam: Baseline mental status, no focal deficits noted. Skin: No evidence of injection sites or lipodystrophy.
Treatment Protocol
Surgical resection (enucleation or distal pancreatectomy) is the definitive treatment. Preoperative localization via EUS, CT, or selective arterial calcium stimulation test. Intraoperative ultrasound utilized for tumor mapping. Post-operative monitoring of serum glucose and insulin levels required.