When Fatty Liver Isn’t the Full Story: Recurrent Hypoglycemia Leading to Insulinoma Diagnosis: A Case Report

Authors

  • Kyrsten Bene' Valentine
  • Andrew Wilson
  • Fernando Magana Herrera

Abstract

Our case is a 33-year-old Hispanic male who was referred to our gastroenterology clinic for evaluation of elevated transaminases and hepatic steatosis. He did have a social history of alcohol use which is a common cause of hepatic steatosis, however our patient had also been having recurrent episodes of hypoglycemia, syncope, and weight gain.1 His symptoms well described Whipple’s triad, a diagnostic hallmark for true hypoglycemia.2 Once imaging and workup had been performed, an insulinoma, an insulin secreting neuroendocrine tumor, was found at the pancreatic tail. Once further imaging and biochemical testing had confirmed the diagnosis, curative surgery was performed. Postoperatively, he had complete resolution of hypoglycemia and significant weight loss. The following case illustrates the diagnostic challenges and multidisciplinary approach involved in identifying and managing insulinoma in a patient initially referred for evaluation of elevated transaminases.

Key words: Insulinoma, Whipple’s Triad, Hepatic Steatosis, Case Report

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Published

2025-12-10

Issue

Vol. 9 No. 5 (2025): Articles

Section

Medical

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