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A Depletion Syndrome in Villous Adenoma of the Rectum

PAUL RABINOWITZ, M.D.; MORTON FARBER, M.D.; ISAAC S. FRIEDMAN, M.D.
Arch Intern Med. 1962;109(3):265-269. doi:10.1001/archinte.1962.03620150015003.
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Although villous adenomas make up as much as 2% of rectal neoplasms,1 there have been but few reports of electrolyte and water depletion which have been associated with these tumors.2-7 This depletion may be of such severity as to cause marked dehydration with anuria, acidosis, sodium, potassium, and chloride loss. The case to be presented here showed these abnormalities. In addition, there were temporary changes in carbohydrate metabolism; electrocardiographic signs of both acute and chronic potassium depletion, as well as intestinal sequestration of fluid in the presence of severe dehydration.

The patient is a 51-year-old female who had 4-5 soft bowel movements daily for 10 years. Intermittently she had episodes of profuse diarrhea accompanied by copious amounts of mucus discharge. An exacerbation of this type developed and persisted for 3 months, resulting in her hospitalization. The mucus discharge was now continuous. She developed extreme fatigability, marked weakness, and

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