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Vipoma

Vipoma, or Verner-Morrison's syndrome (synonyms: A WDHH syndrome from English watery diarrhea, hypokalemia, hypochlorhydria, a syndrome of pancreatic cholera) are caused by hypersecretion of the vasoactive intenstinalny peptide (VIP) (tab).

Etiology

Malignant tumor of a pancreas (90%) or ganglioneyroblastoma (10%). Vipoma, as a rule, represent the solitary, large tumors which more often are located in the tail of a pancreas. At the time of diagnosis in 60 — 80% of cases they already have metastasises.

Pathogeny

Hyperproduction VIP, tumoral progression. The VIP stimulates intestinal secretion of electrolytes and liquid, has vazodila-tatorny effect, inhibits secretion of hydrochloric acid in a stomach.
Epidemiology
Meets casuistic seldom.

Clinical manifestations

Heavy secretory diarrhea which can have the character (pancreatic cholera) menacing for life. Chair volume less than 700 g a day practically excludes Vipoma's diagnosis.
Dehydration symptoms.

Diagnosis

The VIP high level in blood, a hypopotassemia, hypo - or an achlorhydria.
Topical diagnosis of a tumor.

Differential diagnosis

Other reasons of secretory diarrhea (intestinal infections, villezny adenoma, medullary cancer of a thyroid gland, system mastocytosis, etc.).

Treatment

Radical operational treatment of Vipoma, as a rule, is impossible. Drug of the choice of antineoplastic therapy which at the same time effectively stops diarrhea is oktreotid.

Forecast

In most cases adverse.

 
"Bowen's illness   Inborn hemangioma"