Anesthetic Management of Pediatric Pancreatic Insulinoma: A case report. |
Eun Yong Chung, Tae Kwan Kim, Jun Roh Yoon, Jeong Ju Seo, Min Kyu Lee |
Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. eychung@hfh.cuk.ac.kr |
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Abstract |
Insulinomas are the most common type of islet cell tumor.
Generally, these tumors are benign (90%), intrapancreatic, solitary, and small. Moreover, hyperinsulinemia in infants and children can result in permanent damage to the central nervous system. Thus, early diagnosis and treatment are important. The principal challenge during anesthesia is the avoidance of hypoglycemia, which may occur during tumor manipulation, though hyperglycemia may follow after successful surgical removal of the tumor. Because symptoms of hypoglycemia (systemic hypertension, tachycardia, diaphoresis) may be masked during anesthesia, it is important to monitor blood glucose levels frequently during the perioperative period. Here we report up on the case of a 3 year old female with insulinoma. We monitored blood glucose levels intermittently (about every 15 minutes) using a glucometer (Medisense Optium, Abbott, USA). No hypoglycemic episode occurred during anesthesia. We report this clinical experience and review anesthetic choices and the management of this patient. |
Key Words:
insulinoma; isoflurane; pancreas |
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