Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Self-Assessment Questions

General Surgery

Answer 7
  1. Enucleation. Insulinoma is the most common islet cell tumor of the pancreas. Unlike other functional endocrine tumors, insulinomas can be found throughout the pancreatic parenchyma. Characteristic findings of insulinoma are fasting hypoglycemia, symptoms of hypoglycemia, and relief of hypoglycemia with carbohydrate (ie, Whipple triad). The Whipple procedure is not indicated for small masses in the tail of the pancreas. Distal pancreatectomy would be a correct response if the patient had a larger tumor (> 2 cm). This patient has a small tumor (< 2 cm) and therefore enucleation can be performed to remove it. Observation is not appropriate in this setting. suggested readings

    1. Cameron JL, editor. Current surgical therapy. 8th ed. Philadelphia: Elsevier Mosby; 2004.

    2. Townsend CM, Beauchamp RD, Evers BM, et al. Sabiston textbook of surgery: the biological basis of modern surgical practice. 17th ed. Philadelphia: Saunders; 2004.

Click here to return to the questions


Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 6/7/07 • kkj