Pancreatic cholera syndrome due to a vasoactive intestinal polypeptide-producing tumor: Further insights into the pathophysiology

Richard P. Rood, Ronald A. DeLellis, Yogeshwar Dayal, Mark Donowitz

Research output: Contribution to journalArticlepeer-review

Abstract

This case report describes a patient with pancreatic cholera caused by a vasoactive intestinal polypeptide-producing pancreatic tumor. The case presents several unusual characteristics of this disease. The primary tumor was a mucinous adenocarcinoma of the pancreas. The serum vasoactive intestinal polypeptide level of 2400 pmol/L is the highest reported. At this vasoactive intestinal polypeptide level, the somatostatin analogue SMS 201-995 at doses up to 2 mg/24 h did not control the 21 L/24 h stool output. Fecal incontinence due to a manometrically documented hypotonic internal anal sphincter occurred. Using surgically created stomas, the segmental gastrointestinal fluid and sodium losses were shown to be greatest from the jejunum, whereas potassium losses from the colon and small intestine were equal. The cellular mechanism for the small intestinal potassium secretion is not known.

Original languageEnglish (US)
Pages (from-to)813-818
Number of pages6
JournalGastroenterology
Volume94
Issue number3
DOIs
StatePublished - Mar 1988
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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