HYPERINSULINISM SECONDARY TO DISEASE OF THE PANCREAS AND ORGANS ADJACENT TO THE PANCREAS: A REVIEW OF THE WORLD LITERATURE

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Abstract
Attention is directed to the occasional occurrence of hyperinsulinism in patients with chronic pancreatitis, cirrhosis and atrophy of the pancreas due to obstruction of the pancreatic duct by concrements or tumor, and disease of the gastrointestinal or biliary tract. The hyperinsulinism is attributed to hyperplasia and neoformation of the islands of Langerhans following injury to the pancreas, and a shift of the alpha-beta cell ratio in favor of the insulin-producing beta cells. These changes were histologically proved in 22 of the 43 cases compiled in this paper. The histologic picture resembles closely that which has been observed in animal experiments after ligation of the pancreatic duct or partial resection of the pancreas. Chronic inflammation and hyperemia of the pancreas, dilatation of the pancreatic ductules, and hyperglycemia are considered possible stimuli for the hyperplasia and hyperfunction of the islands. Review of the literature of the last 25 years reveals that this syndrome has been repeatedly described in the foreign literature but has not been recognized as such in this country.

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