{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T13:09:58Z","timestamp":1779109798133,"version":"3.51.4"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,9,4]],"date-time":"2021-09-04T00:00:00Z","timestamp":1630713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Insulinomas are rare in the post-bariatric surgery setting. The differential diagnosis for hypoglycemia is broad, requiring laboratory testing to verify endogenous hyperinsulinemic hypoglycemia. Selective arterial calcium stimulation testing (SACST) can help localize abnormal insulin production. We describe a patient with histologically confirmed insulinoma after bariatric surgery diagnosed with the aid of SACST.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We present a 67 year old woman with a history of Roux-en-Y bypass surgery who presented with endogenous hyperinsulinemic hypoglycemia. Initially, no pancreatic lesion was identified radiologically. We pursued SACST to localize the source of insulin production.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The SACST successfully localized the source of hyperfunctioning islet cells to the pancreatic tail with absolute insulin values in a range consistent with insulinoma. Additional radiologic studies showed a small tumor in the pancreatic tail. Pathology showed a well-differentiated neuroendocrine tumor, compatible with insulinoma.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This case study illustrates the usefulness of SACST for the diagnosis and localization of insulinoma.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/labmed\/lmab071","type":"journal-article","created":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T19:10:11Z","timestamp":1626981011000},"page":"e40-e43","source":"Crossref","is-referenced-by-count":2,"title":["Use of Selective Arterial Calcium Stimulation Testing in Identification of Insulinoma in a Patient After Bariatric Surgery"],"prefix":"10.1093","volume":"53","author":[{"given":"Julianne M","family":"Szczepanski","sequence":"first","affiliation":[{"name":"Department of Pathology, University of Michigan, Ann Arbor, Michigan , US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika","family":"Hissong","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Michigan, Ann Arbor, Michigan , US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M","family":"Manthei","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Michigan, Ann Arbor, Michigan , US"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,9,4]]},"reference":[{"issue":"3","key":"2023111812345316600_CIT0001","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1210\/jc.2008-1410","article-title":"Evaluation and management of adult hypoglycemic disorders: an Endocrine Society clinical practice guideline","volume":"94","author":"Cryer","year":"2009","journal-title":"J Clin Endocrinol 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the Mayo Clinic, 1987-2007","volume":"94","author":"Placzkowski","year":"2009","journal-title":"J Clin Endocrinol Metab."}],"container-title":["Laboratory 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