Postprandial Hypoglycemia Resulting From Nasogastric Tube Malposition

¹ Department of Pediatrics, University of Wisconsin School of Medicine, Madison

Recurrent, severe hypoglycemia in infants and children usually reflects an immature or defective adaptation to fasting (postabsorptive hypoglycemia). Rarely, however, symptoms of hypoglycemia occur predominantly in the postprandial period (less than four hours after a meal). Recent studies have focused attention on postprandial hypoglycemia as a manifestation of the late postprandial dumping syndrome in children following gastric surgery.^1,2 In this setting, hypoglycemia is attributed to reactive hyperinsulinemia following a rapid initial increase in blood glucose concentration.³ We report the finding of severe, recurrent hypoglycemia in a nonsurgical patient receiving nasogastric feedings. In this patient, inadvertent intubation of the proximal small bowel simulated the altered gastrointestinal dynamics associated with the late postprandial dumping syndrome.

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