When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

VIPoma

Last reviewed: 23 Jun 2024
Last updated: 19 Jul 2024

Summary

Definition

History and exam

Key diagnostic factors

  • profuse watery diarrhea
Full details

Other diagnostic factors

  • age around 50 years
  • headache
  • weight loss
  • poor skin turgor
  • dry mucus membranes
  • muscle weakness
  • muscle cramps
  • flushing
  • hepatomegaly
  • history of multiple endocrine neoplasia type 1 (MEN1)
Full details

Risk factors

  • multiple endocrine neoplasia type 1 (MEN1)
  • age around 50 years
Full details

Diagnostic tests

1st tests to order

  • serum potassium
  • serum bicarbonate
  • serum calcium
  • serum glucose
  • vasoactive intestinal peptide (VIP) radioimmunoassay
  • liver function tests
Full details

Tests to consider

  • arterial blood gas analysis
  • gastric pH monitoring
  • chromogranin A
  • pancreatic polypeptide
  • contrast-enhanced CT scan of abdomen
  • contrast-enhanced MRI of abdomen
  • somatostatin receptor PET/CT
  • somatostatin receptor scintigraphy
  • endoscopic ultrasound
  • abdominal ultrasound
  • operative exploration
  • intraoperative ultrasound
Full details

Treatment algorithm

ACUTE

initial presentation of symptomatic patient

ONGOING

localized disease

metastatic disease: surgical candidate

metastatic disease: nonsurgical candidate

refractory disease

Contributors

Authors

Harish Lavu, MD, FACS
Harish Lavu

Professor of Surgery

Sidney Kimmel Medical College

Thomas Jefferson University

Philadelphia

PA

Disclosures

HL declares that he has no competing interests.

Charles J. Yeo, MD, FACS
Charles J. Yeo

The Samuel D. Gross Professor and Chair

Department of Surgery

Sidney Kimmel Medical College

Thomas Jefferson University

Philadelphia

PA

Disclosures

CJY declares that he has no competing interests.

Peer reviewers

Jaime Ruiz-Tovar, MD

Fellow of the Spanish Association of Surgeons (AEC)

Department of Surgery

University Hospital Ramon y Cajal

Madrid

Spain

Disclosures

JRT declares that he has no competing interests.

Christopher Wolfgang, MD, PhD, FACS

Assistant Professor of Surgery and Oncology

Cameron Division of Surgical Oncology

The Sol Goldman Pancreatic Cancer Research Center

Johns Hopkins University

Baltimore

MD

Disclosures

CW declares that he has no competing interests.

  • VIPoma images
  • Differentials

    • Infectious gastroenteritis
    • Osmotic diarrhea
    • Ileal bile acid malabsorption
    More Differentials
  • Guidelines

    • NCCN clinical practice guidelines in oncology: neuroendocrine and adrenal tumors
    • NCCN clinical practice guidelines in oncology: neuroendocrine and adrenal tumors
    More Guidelines
  • Patient information

    Diarrhea in adults

    Diarrhea in children

    More Patient information
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer