UNIVERSITAS AIRLANGGA



Detail Article

Folia Medica Indonesiana

ISSN 0303-7932

Vol. 39 / No. 4 / Published : 2003-10

Order : 12, and page :269 - 276

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Original Article :

Subtotal pancreatectomy for persistent hyperinsulinemia hypoglycemia in neonate (a case report)

Author :

  1. Sylviati Thahir Damanik*1
  2. Netty EP*2
  3. Kustiyo Gunawan*3
  4. Mira Irmawati*4
  5. Agus Harianto*5
  1. Department of Child Health, Airlangga University School of Medicine Dr Soetomo Teaching Hospital, Surabaya
  2. Department of Child Health, Airlangga University School of Medicine Dr Soetomo Teaching Hospital, Surabaya
  3. Department of Surgery, Airlangga University School of Medicine Dr Soetomo Teaching Hospital, Surabaya
  4. Department of Child Health, Airlangga University School of Medicine Dr Soetomo Teaching Hospital, Surabaya
  5. Department of Child Health, Airlangga University School of Medicine Dr Soetomo Teaching Hospital, Surabaya

Abstract :

Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is rare condition of inappropriate and excessive insulin secretion from & beta; cell hyperplasia of pancreas. The incidence in general population is 1 : 50,000 live birth. The refractory hypoglycemia may produce brain damage unless effective treatment at an early stage. The mainstay of medical treatment includes increasing carbohydrate intake feeds or intravenous glucose at a rate above 15 mg/kg bw/minute and octreotide. If these measures fail surgical esection should be considered. We reported the difficulty of management a case with diagnosis of PHHI. NS, 12 days of age female, ,200 gram from Sidoarjo was referred to Dr Soetomo Hospital with diagnosis of refractory hypoglycemia. She suffered from eizures, 3 times of apnea, and several hypoglycemia episodes. She had received some medication includes several boluses of 40% of extrose solution, 10% of dextrose infusion, Dexamethazone, and antibiotic. She was born spontaneously with the body weight of 000 gram, and head circumference of 33 cm. There was no history of diabetic mother. In our hospital, we treated her with high rate of glucose infusion about 15 mg/kgbw/minute, frequent feeding (via oral and nasogastric tube). Up to day 6 of spitalization theepisodes of hypoglycemia still persisted, the treatment added with octreotide 8 μg/kgbw/day in divided doses. The hypoglycemia pisodes disappeared after that. She was performed of Abdominal USG and CT Scan that indicated of tumor of corpus pancreas. The aboratory examination revealed: very high result of C-peptide (3.3 ng/l) with no keton body. She was performed subtotal ancreatectomy 95% one month later, because of social judgement. And the histological examination revealed of diffuse pancreatic eta cell hyperplasia. The several hyperglycemia episodes were occurred until 4 days after operation, and insulin was given if the lood glucose & gt; 110 mg/dl. The baby was discharge d on day 66 of hospitalization (78 day of age) with normal blood glucose evel, and head circumference of 34 cm (microcephali). On the follow-up examination (7 months of age), she was in a good condition with no symptom of hypo or hyperglycemia, and normal blood glucose level. The head circumference was 42 cm.

Keyword :

hypoglycemia, pancreatectomy,


References :

Ansley GA et al,(2000) Practical management of hyperinsulinsm in infancy - : Arch Dis Child Fetal Neonatal Ed

Cloherty JP, Stark AR,(1998) Manual of Neonatal Care 4th edition Philadelphia : Lippincott Williams & Wilkins





Archive Article

Cover Media Content

Volume : 39 / No. : 4 / Pub. : 2003-10
  1. Editorial Vol 39 No 4 2003
  2. Opinion: Medical Molecular Surgery
  3. Expression Of Bcl-2 And P53 In Uterine Cervical Cancer
  4. The Pattern Of Immunopathobiological Response In Oral Mucosa To Disclose The Immunopathobiogenesis Of Candida Albicans Infection In Patients With Diabetes Mellitus
  5. Efficacy Of Low Dose Sublingual Immunotherapy In Childhood Asthma
  6. Stature And Weight Of Indonesian Children Compared To Nchs-reference
  7. Review Article And Clinical Experience: The Roles Of Micronutrients In The Treatment Of Diabetes Mellitus (focus On Chromium And Specific Nutrients)
  8. The Latest Clinical Epidemiological Data Of Ischemic And Hemorrhagic Stroke Patients In Surabaya And The Surroundings A Hospital-based Study
  9. Postnatal Depression In Three Hospitals In Surabaya
  10. The Attitude Improvement Among Community Health Center Staff In Managing The Risk And Resolving Malnutrition In Underfives By Using Estimation Score
  11. The Difference Between Adolescents With And Without Conduct Disorder In Assessing Their Family Function
  12. Subtotal Pancreatectomy For Persistent Hyperinsulinemia Hypoglycemia In Neonate (a Case Report)

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