Blurred Vision and Palpitations in a Young Woman

October 7, 2014

Intermittent blurred vision and palpitations in a young woman often improve after juice. She does not have DM. One day, she arrives at the ED after a seizure. Head CT is negative. What’s next?

A 26-year-old woman experiences occasional blurring of her vision and palpitations. Her symptoms often improve after drinking juice. She does not have a history of diabetes mellitus. One day, she presents to the ER after experiencing a seizure. The result of a head CT performed in the ED is negative. Her blood glucose is 30 mg/dL and she is given intravenous dextrose solution. During her work-up, an abdominal CT is performed which is notable for a mass in the head of the pancreas (Figure, see broken blue line). 

1. What is the most likely cause of this patient’s clinical presentation?

2. What is the name of the triad described?

3. What is the next step in management?

 

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