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Are there any specific CT scans available to detect insulinoma?

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Posted on Thu, 12 May 2016
Question: To search for insulinoma is an abdominal ct scan the required one or is there a pancreas specific ct scan ? Thanks
doctor
Answered by Dr. Iven Romic Rommstein (1 hour later)
Brief Answer:
CT scan with contrast

Detailed Answer:
Hi and welcome.
CT scan is gold standard for detecting insulinoma and other pancreatic tumors but is should be done with intravenous contrast. also,as a routine part of work up ,is endoscopic ultrasound which has 85% sensitivity. MRI and somatostatin scintigraphy are used when finding is doubtful. all in all, ct scan, abnormal glucose and insulin fluctuations and clinical picture should be enough to establish right diagnosis. Wish you good health. Regards
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Iven Romic Rommstein (21 minutes later)
Thanks so much but i had a pelvic- abdominal ct scan with contrast is this the one or is there a scan needed for the pancreas only ie like focusing only on pancreas? Sorry for the ignorant question :)
doctor
Answered by Dr. Iven Romic Rommstein (7 minutes later)
Brief Answer:
See next

Detailed Answer:
Hi.
no,there is no pancreas specific ct scan. there is abdominal ct scan with contrast which visualize all intrabdominal organs and then everything can be magnified and examined in details.so you 've done test that is enough to evaluate pancreas lesions.
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Iven Romic Rommstein (9 hours later)
Thanks so much
doctor
Answered by Dr. Iven Romic Rommstein (28 hours later)
Brief Answer:
You re welcome

Detailed Answer:
you 're welcome
Above answer was peer-reviewed by : Dr. Deepak
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Follow up: Dr. Iven Romic Rommstein (14 minutes later)
Thanks ; what gastrointestinal diseases mimic hypoglycemia symptoms and which are relieved also upon eating ?
doctor
Answered by Dr. Iven Romic Rommstein (9 hours later)
Brief Answer:
few possible causes

Detailed Answer:
Hi.
Insulinoma is one of them but other neuroendocrine tumors in small bowels or duodenum may lead to it as well. Also, hormonal imbalance, not just insulin, but cortisol or steroids, may be caused by disorders or adrenal glands.

Liver cirrhosis, Gastric dumping syndrome after surgeries may cause it as well.

Sometimes no cause is found and then it is called as Idiopathic Postprandial Syndrome or reactive hypoglycemia and it should be treated with diet rich in sugar or glucagon injections.

Wish you good health.
Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Iven Romic Rommstein (10 hours later)
But here hypoglycemia is defined as low blood sugar that is below 40 mg/dl ? What about hypoglycemic symptoms at higher glucose levels . I get hypos because my glucose drops fast , for example from 180 to 60 in an hour span on the GTT. Although my fasting glucose is 100 or so .. also sometimes after eating carbs it reaches 220 or so and it can drop by 50 mg/dl in one hour . Would this pattern be more consistent with tumors or other causes like hormonal imbalance or prediabetes or reactive hypo ? I did a CT scan and no tumors showed . would you recommend endoscopy ? i did have appendectomy a few months ago ...
doctor
Answered by Dr. Iven Romic Rommstein (7 hours later)
Brief Answer:
both is possible

Detailed Answer:
Hi.
It can be both. It is not easy to define exact cause, but you should first rule out neuroendocrine tumors so do lab tests: chromogranin A (CgA) in
urine and 5-hydroxyindoleacetic acid. I dont think endoscopy is required if ct scan was fine. But you should see diabetologist and do extensive laboratory work up to define triggers for glucose fluctuations. This may not be just gastrointestinal cause but also disorders in hypotalamus, kidneys and adrenal glands
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Iven Romic Rommstein (43 minutes later)
Thanks so much im meeting an endocrinologist in london soon . Many thanks
doctor
Answered by Dr. Iven Romic Rommstein (4 hours later)
Brief Answer:
you re welcome

Detailed Answer:
you re welcome
Above answer was peer-reviewed by : Dr. Naveen Kumar
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Dr. Iven Romic Rommstein

General Surgeon

Practicing since :2008

Answered : 13869 Questions

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Are there any specific CT scans available to detect insulinoma?

Brief Answer: CT scan with contrast Detailed Answer: Hi and welcome. CT scan is gold standard for detecting insulinoma and other pancreatic tumors but is should be done with intravenous contrast. also,as a routine part of work up ,is endoscopic ultrasound which has 85% sensitivity. MRI and somatostatin scintigraphy are used when finding is doubtful. all in all, ct scan, abnormal glucose and insulin fluctuations and clinical picture should be enough to establish right diagnosis. Wish you good health. Regards