Villous adenoma of the colon

Patients with villous adenoma of the colon may sustain substantial fluid and electrolyte losses resulting from a voluminous mucous diarrhea composed of the secretion of the tumor. Such a patient is described, and fluid and electrolyte disturbances in this case and in others reported in the literature are reviewed. The symptoms are rapidly progressing weakness and gastrointestinal complaints. The patient may present in collapse, with confusion or coma. On rectal examination, the tumor may be felt or the mucous diarrhea may be observed. These patients display a combination of dehydration, hyponatremia and hypokalemia. Azotemia may be severe even in the absence of renal disease. Early in the illness they are either alkalotic or in normal acid-base balance; as fluid losses become more severe, acidosis supervenes. The present patient was treated with large amounts of fluids and potassium followed by resection of the tumor.