Improvement of Glucose Tolerance after Resection of a Mucin-producing Pancreatic Tumor in an Elderly NIDDM Patient.
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We report herein an elderly-woman with a pancreatic tumor, who showed transient glucose intolerance requiring insulin therapy. She was diagnosed as having NIDDM with moderately decreased urinary C-peptide excretion, but had no family history of diabetes. Although serum levels of amylase and pancreatic secretory trypsin inhibitor were slightly increased on admission, she had no complaints of abdominal pain or jaundice-associated symptoms except for weight loss and symptoms related to hyperglycemia. The main pancreatic duct was cystically dilated on CT scan. Furthermore, mucus excretion was endoscopically observed through the markedly dilated orifice of the enlarged ampulla of Vater, suggesting the presence of a mucin-producing pancreatic tumor. After pancreaticoduodenectomy for the pancreatic tumor, the specimen was confirmed to be an intraductal papillary adenoma. After removal of the tumor, glucose intolerance improved markedly, and insulin therapy was not required because of an increase in insulin secretion. Thus, decreased insulin secretion, probably due to partial obstruction by gradual growth of the pancreatic tumor, may have been involved in the preoperative deterioration of glucose tolerance in this patient.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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