Secretory villous adenomas that cause depletion syndrome

Secretory villous adenomas of the colon have been known to cause a depletin g syndrome characterized by dehydration, prerenal azotemia, hyponatremia, h ypokalemia, metabolic acidosis, obtundation, and, in severe cases, death. W e describe 1 case of classic depleting syndrome and review the literature o n possible mechanisms. Both cyclic adenosine monophosphate and prostaglandi n E-2 have been implicated as possible secretagogue compounds in the pathog enesis of this syndrome unique to the secretory variant form of villous ade nomas, Indomethacin as a prostaglandin inhibitor has been used with apparen t benefit in controlling the volume of rectal effluent in patients with sec retory villous adenomas.