Cooperman A M, Desantis D, Winkelman E, Farmer R, Eversman J, Said S
Ann Surg. 1978 Mar;187(3):325-8. doi: 10.1097/00000658-197803000-00020.
Two unusual cases of the watery diarrhea syndrome are presented. In one patient an adrenal medullary tumor, a pheochromocytoma that produced vasoactive intestinal polypeptide (VIP) was excised with total relief of symptoms. The second patient a 65-year-old man with abrupt onset of massive watery diarrhea that led to acidosis and coma was symptomatically controlled for one year on 10 mg/day of prednisone. Elevated levels of VIP returned to normal after prednisone therapy was started. A benign islet cell tumor not localized by angiography was removed by distal pancreatic resection. Tissue levels of VIP were markedly elevated. VIP is a humoral mediator of the water diarrhea syndrome. Both benign and malignant pancreatic and extrapancreatic tumors may cause the watery diarrhea syndrome. Steroids may cause symptomatic relief of the diarrhea by lowering peptide levels to normal. The term watery diarrhea syndrome may be more accurate than the pancreatic cholera syndrome.
本文介绍了两例罕见的水样腹泻综合征病例。其中一例患者患有肾上腺髓质肿瘤，即分泌血管活性肠肽（VIP）的嗜铬细胞瘤，切除该肿瘤后症状完全缓解。第二例患者是一名65岁男性，突然出现大量水样腹泻，导致酸中毒和昏迷，每天服用10毫克泼尼松对症治疗一年。开始泼尼松治疗后，升高的VIP水平恢复正常。通过远端胰腺切除术切除了经血管造影未定位的良性胰岛细胞瘤。肿瘤组织中的VIP水平明显升高。VIP是水样腹泻综合征的一种体液介质。胰腺和胰腺外的良性及恶性肿瘤均可导致水样腹泻综合征。类固醇可通过将肽水平降至正常而使腹泻症状缓解。水样腹泻综合征这一术语可能比胰性霍乱综合征更准确。
