Continuous subcutaneous insulin usage in a patient with no gut

摘要

Gardner's syndrome is a rare autosomal dominant condition characterized by colonic polyposis and multiple soft- and hard-tissue tumours. It is a variant of familial adenomatous poylposis coli (FAP) and a result of similar genetic mutations [1]. Patients with Gardner's syndrome frequently undergo surgical removal of large portions of their gastrointestinal tract to prevent the development of colonic neoplasms. As a result, total parenteral nutrition (TPN) is used when the gastrointestinal tract is nonfunctional or non-existent. Although uncommon among the extra intestinal features of Gardner's syndrome, numerous endocrine manifestations have been reported. These include thyroid cancer, adrenal adenomas, parathyroid adenomas, pituitary chromophobe adenomas and pancreatic islet cell adenomas [2-7].