Effect of a Long-Acting Somatostatin Analogue (SMS 201–995) in a Patient with Pancreatic Cholera

Abstract

PANCREATIC cholera is characterized by watery diarrhea, hypokalemia, and acidosis1 and in most cases is due to a non-β-islet-cell tumor of the pancreas that secretes vasoactive intestinal polypeptide (VIP) and peptide histidine isoleucine.2 When such tumors are localized to the pancreas, surgical resection may produce a cure, and in patients with metastatic disease streptozocin may reduce the tumor's size and control the symptoms.3 A variety of other agents — corticosteroids,4 lithium,5 metoclopramide,6 clonidine,7 trifluoperazine,8 and indomethacin9 — may also occasionally reduce the diarrhea, and continuous intravenous infusion of somatostatin has also been reported to reduce diarrhea and decrease plasma concentrations . . .