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McKittrick-Wheelock syndrom: Complication of rectal mucinous adenoma


Authors: R. Škuta;  M. Danaj;  I. Duda;  A. Dobrovodský
Authors‘ workplace: Chirurgická klinika FN Trnava a FZSP Trnavskej Univerzity, prednosta: Prof. MUDr. Miroslav Danaj, CSc.
Published in: Rozhl. Chir., 2012, roč. 91, č. 4, s. 246-248.
Category: Case Report

Overview

The McKittrick-Wheelock syndrome is a very rare complication of rectal villous adenoma, characterized by fluid and electrolyte hypersecretion from a rectal tumour, which can lead to acute renal failure.

We present a case review of a 67 –year old male patient hospitalised for profuse secretory diarrhea, with electrolyte dysbalance and progressive renal failure. A rectoscopic finding of massive rectal adenoma contributed to establishing the correct diagnosis. Resection of the affected part of the rectum resulted in rapid restoration from mineral imbalance and improvement of renal functions.

The reported case shows the necessity of interdisciplinar management and the importance of surgical treatment in patients with this rare diagnosis.

Key words:
McKittrick – Wheelock syndrom – acute renal failure – hypersecretory diarrhea – rectal mucinous adenoma – abdominoperineal rectal resection


Sources

1. McKittrick LS, Wheelock FC, Jr. Carcinoma of the colon. Springfield, Charles, C. Thomas, 1954:61.

2. Jacob H, Schlondorff D, St. Onge G, Bernstein LH, et al. Villous adenomadepletion syndrome. Evidence for a cyclic nucleotide-mediated diarrhea. Dig Dis Sci 1985;30:637–641.

3. Lepur D, Klinar I, Miše B, Himbele J, Vranjican Z, et al. McKittrick-Wheelock syndrome: a rare cause of diarrhoea. European Journal of Gastroenterology and Hepatology 2006;18:557–559

4. Martins HS, Brandao-Neto RA, De Carvalho AL, et al. McKittrick-Wheelock syndrome: a cause of severe hydroelectrolyte disorders in ED. American Journal of Emergency Medicine 2007;25:1083.e1–1083.e3

5. Popescu A, Orban-Schiopu AM, Becheanu G, Diculescu M, at al. McKittrick-Wheelock syndrome - a rare cause of acute renal failure. Romanian Journal of Gastroenterology 2005;124:63–66

6. Winstanley V, Little MA, Wadsworth C, Cohen P, Martin NM, et al. The McKittrick - Wheelock syndrome: a case of acute renal failure due to neoplastic cholera., Colorado, Ren Fail 2008; 469–73.

7. Pugh S, Thomas GAO. Patients with adenomatous polyps and carcinomas have increased colonic mucosalprostaglandin E2. Gut., 2006;675–678.

Labels
Surgery Orthopaedics Trauma surgery
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