Differential haematological and instrumental examinations (OGTT, protracted fasting, i.v. tolbutamide, blood insulin, pancreatic scintiscanning, oesophagogastroduodenoscopy, panoramic abdominal arteriography, and selective arteriography of the coeliac trunk), preceded subtotal pancreasectomy in a severe case of hypoglycaemia attributable to organic hyperinsulinism. Epstein's method was used to extract insulin from the pancreatic tissue for radioimmunological assay.
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