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- FIGURE 37.5-3. Serum insulin after intraarterial calcium gluconate
- graph in a patient with an occult insulinoma. Blood samples are drawn
- from the right hepatic vein before (time 0) and at various times after
- bolus administration of calcium into the selective mesenteric vessels.
- The increase in insulin is highest after injection into the
- gastroduodenal artery (GDA), shows a mild increase after injection
- into the superior mesenteric artery (SMA) and shows essentially no
- step-up in the splenic artery and hepatic artery injection. This
- gradient in the GDA with a smaller step-up in the SMA indicates that
- the patient likely has an insulinoma that is located within the area
- of the pancreatic head.
-