Clinical Observation
April 26, 1999

Secretory Villous Adenomas That Cause Depletion Syndrome

Author Affiliations

From the Departments of Medicine (Drs J. Older and Colker) and Pathology (Drs P. Older and Brown), Berkshire Medical Center, Pittsfield, Mass.


Copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1999

Arch Intern Med. 1999;159(8):879-880. doi:10.1001/archinte.159.8.879

Secretory villous adenomas of the colon have been known to cause a depleting syndrome characterized by dehydration, prerenal azotemia, hyponatremia, hypokalemia, metabolic acidosis, obtundation, and, in severe cases, death. We describe 1 case of classic depleting syndrome and review the literature on possible mechanisms. Both cyclic adenosine monophosphate and prostaglandin E2 have been implicated as possible secretagogue compounds in the pathogenesis of this syndrome unique to the secretory variant form of villous adenomas. Indomethacin as a prostaglandin inhibitor has been used with apparent benefit in controlling the volume of rectal effluent in patients with secretory villous adenomas.