RESUMO
Objective: To evaluate the value of intraductal ultrasonography (IDUS) in diagnosis of pancreatic diseases. Methods: We retrospectively reviewed the imaging data of 63 patients with pancreatic diseases who underwent IDUS from February 2005 to February 2010. A 20 MHz over-the-guidewire intraductal US catheter probe was used during endoscopic retrograde cholangio- pancreatography(ERCP) for further examination of the pancreas. We also compared the results of CT, magnetic resonance imaging (MRI), endoscopic ultrasonography (EUS) and abdominal ultrasonography in diagnosis of pancreatic diseases, so as to further evaluate the value of IDUS in the clinical diagnosis of pancreatic diseases. Results: The accuracies of IDUS in diagnosis of chronic pancreatitis (23 cases), pancreatic cancer (10 cases), intraductal papillary mucinous tumors (IPMT, 25 cases), and pancreatic adenoma (4 cases) were 93. 7% (59/63), 100.0% (63/63), 90.5% (57/63), and 96.8% (61/63), and the Kappa values were 0.854, 1.00, 0.898, and 0.848, respectively. The diagnostic accuracies and Kappa test values of IDUS were better than those of the other four methods. IDUS correctly diagnosed the pancreatic cystadenocarcinoma in one patient before operation. Conclusion: IDUS has a high diagnostic value for pancreatic diseases.
RESUMO
Hyperinsulinemic hypoglycemia is a relatively rare disease in childhood period except neonate, but hypoglycemia due to delicate imbalance between glucose production & consumption is evoked easily and left permanent damage to brain at these period. The definition is that serum insulin level is above 10microU/ml when blood sugar level is below the 40mg/dl and so I/G ratio is higher than 0.4. The clinical manifestations are irrtability, frequent feeding and seizures etc. and there is no specific pancreatic pathology in most cases. We experienced 2 cases of hyperinsulinemic hypoglycemia with pancreatic hyperplasia and pancreatic adenoma each other. The diagnosis was made on clinical manifestations, laboratory results, radiologic and pathologic findings. We reported these cases with brief review of literature.