gastrointestinal disorders
Vipoma
Treatment of Vipoma
Fluid and electrolyte replacement Octreotide Surgical resection for localized disease Initially, fluids and electrolytes must be replaced. Bicarbonate must be given to replace fecal loss and avoid acidosis. Because fecal losses of water and electrolytes increase as rehydration is achieved, continual IV replacement may become difficult. Octreotideusually controls diarrhea, but large doses may be needed. Responders may benefit from a long-actingoctreotideformulation. Patients usingoctreotidemay also need to take supplemental pancreatic enzymes becauseoctreotidesuppresses pancreatic enzyme secretion. Tumor resection is curative in 50% of patients with a localized tumor. In patients with metastatic tumor, resection of all visible tumor may provide temporary relief of symptoms. The combination ofstreptozocinanddoxorubicinmay reduce diarrhea and tumor mass if objective response occurs (in 50 to 60%). Newer chemotherapies under investigation for vipoma includetemozolomide-based regimens,everolimus, orsunitinib. Chemotherapy is not curative. 