Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, profuse, secretory watery diarrhea (WDHA syndrome: Watery Diarrhea, Hypokalemia, Achlorhydria). Symptoms include significant electrolyte depletion, muscle weakness, and episodic flushing. Onset is insidious with progressive frequency and volume of stool, unresponsive to fasting. Associated symptoms include abdominal cramping, lethargy, and weight loss.
Clinical Examination Findings
Vitals: Orthostatic hypotension, tachycardia. General: Signs of severe dehydration, dry mucous membranes, reduced skin turgor. Abdomen: Soft, non-tender, hyperactive bowel sounds. Neurological: Generalized muscle weakness and hyporeflexia secondary to profound hypokalemia. Skin: Possible flushing or erythematous patches.
Treatment Protocol
Immediate stabilization: Aggressive IV fluid resuscitation and electrolyte replacement (specifically potassium). Pharmacological: Initiation of Somatostatin analogs (Octreotide) to inhibit VIP secretion. Surgical: Surgical resection of the pancreatic tumor (primary treatment). Supportive: Proton pump inhibitors (PPIs) for achlorhydria management and nutritional support.