Verner-Morrison Syndrome Presenting as Acute Persistent Diarrhea

Vasoactive intestinal peptide (VIP)-producing tumors account for 10% of all neuroendocrine tumors of the pancreas. The Verner-Morrison syndrome is caused by VIP-producing tumors. It is a rare entity with an incidence of 1/10 million individuals per year. About 800 cases have been reported worldwide. Pancreatic VIPomas are usually solitary. Clinical manifestations are long-standing secretory diarrhea associated to biochemical abnormalities such as hypokalemia, hypochloremia and metabolic acidosis, presentation as acute diarrhea is rare. Up to 60% of tumors are malignant and among these, 60-80% have metastasized at diagnosis. Part of the symptomatic treatment is based on somatostatin analogs; definitive treatment depends on the disease’s extent but surgical resection is the treatment of choice of localized tumors.