{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T14:14:12Z","timestamp":1783347252279,"version":"3.54.6"},"reference-count":12,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,6,26]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>A woman in her 60s presented to the emergency department with an 18-month history of chronic secretory diarrhoea and 8\u2009kg weight loss. She had multiple previous presentations to healthcare for dehydration, weakness and severe hypokalaemia (serum potassium &lt;2.5\u2009mmol\/L) over the preceding 18 months. Previous colonoscopy and workup for infectious and inflammatory causes had not yielded a diagnosis. At presentation, her serum potassium was 2.1 mmol\/L (reference 3.5\u20135\u2009mmol\/L) with evidence of muscle weakness and volume depletion. A CT of the abdomen and pelvis demonstrated an 8 cm mass in the pancreatic tail. Endoscopic biopsy demonstrated well-differentiated pancreatic neuroendocrine tumour. Serum vasoactive intestinal peptide (VIP) was elevated eightfold above the upper limit of normal, in keeping with the diagnosis of VIPoma. Long-acting somatostatin analogue (SSA) was initiated. The patient underwent surgical resection of the primary tumour for symptom control. Following surgery and ongoing SSA use, diarrhoea and hypokalaemia have resolved.<\/jats:p>","DOI":"10.1136\/bcr-2026-274867","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T13:13:47Z","timestamp":1783343627000},"page":"e274867","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["<b>Severe hypokalaemia and secretory diarrhoea secondary to a vasoactive intestinal peptide-secreting tumour (VIPoma<\/b>\n                    )"],"prefix":"10.1136","volume":"19","author":[{"given":"Lenka","family":"Stafl","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Ruzycki","sequence":"additional","affiliation":[{"name":"Division of General Medicine, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Kline","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirstie","family":"Lithgow","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"2026070606050924000_19.7.e274867.1","doi-asserted-by":"crossref","first-page":"2712","DOI":"10.1001\/jama.2016.7833","article-title":"Persistent Diarrhea: A Clinical Review","volume":"315","author":"DuPont","year":"2016","journal-title":"JAMA"},{"key":"2026070606050924000_19.7.e274867.2","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1001\/jama.2026.0872","article-title":"Chronic, Noninfectious Diarrhea: A Review","volume":"335","author":"Singh","year":"2026","journal-title":"JAMA"},{"key":"2026070606050924000_19.7.e274867.3","first-page":"472","article-title":"Chronic Diarrhea in Adults: Evaluation and Differential Diagnosis","volume":"101","author":"Burgers","year":"2020","journal-title":"Am Fam Physician"},{"key":"2026070606050924000_19.7.e274867.4","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1016\/j.dld.2015.06.015","article-title":"Pancreatic exocrine insufficiency in pancreatic cancer: A review of the literature","volume":"47","author":"Bartel","year":"2015","journal-title":"Dig Liver Dis"},{"key":"2026070606050924000_19.7.e274867.5","doi-asserted-by":"crossref","first-page":"8251","DOI":"10.1097\/JS9.0000000000004229","article-title":"New-onset diabetes mellitus after distal pancreatectomy research status, trends, and risk factors","volume":"112","author":"Waili","year":"2026","journal-title":"International Journal of Surgery"},{"key":"2026070606050924000_19.7.e274867.6","unstructured":"Smith JL . Olivia williams: i\u2019ll never be cancer-free. The Times; 2025. 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