RSS-Feed abonnieren
PDF herunterladen
DOI: 10.1055/s-0043-1773781
McKittrick Wheelock Syndrome Secondary to Adenocarcinoma of the Rectum. Case Report and Diagnostic Considerations
Abstract
Introduction McKittrick-Wheelock syndrome is a rare entity characterized by chronic diarrhea, acute kidney injury, and hydroelectrolytic imbalance associated with a large rectal tumor, frequently a villous adenoma.
Case report A 69-year-old male with chronic diarrhea with mucus. He underwent a colonoscopy with biopsies, reporting adenocarcinoma of the rectum in situ, and underwent a robot assisted intersphincteric resection with colo-anal anastomosis and a protecitive ileostomy.
Discussion Described in 1954, this syndrome is manifested by electrolyte imbalance and acute renal injury secondary to diarrhea associated with a rectal villous adenoma, often with long lasting symptoms. The most frequent symptom being watery diarrhea with mucus. The definitive treatment consists of surgical resection.
Conclusion Although this is a rare pathology, it should be considered as a differential diagnosis in cases of chronic diarrhea associated with water and electrolyte disorders.
Publikationsverlauf
Eingereicht: 20. September 2022
Angenommen: 14. August 2023
Artikel online veröffentlicht:
21. September 2023
© 2023. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
References
- 1 Orchard MR, Hooper J, Wright JA, McCarthy K. A systematic review of McKittrick-Wheelock syndrome. Ann R Coll Surg Engl 2018; 100 (08) 1-7
- 2 Martins BA, Gomes AC, de Almeida Santos ME, Moreira NM, de Almeida RM, de Sousa JB. McKittrick-Wheelock Syndrome Secondary to Rectal Adenocarcinoma. J Coloproctol (Rio J) 2022; 42 (02) 187-189
- 3 Raphael MJ, McDonald CM, Detsky AS. McKittrick-Wheelock syndrome. CMAJ 2015; 187 (09) 676-678
- 4 de Sousa Miranda I, Ferreira JR, Rocha S, Monteiro M, Guillerme J, Domingos R. McKittrick-Wheelock Syndrome: A Neoplastic Cause of Electrolyte Imbalance. Eur J Case Rep Intern Med 2022; 9 (03) 003231
- 5 Podestà MA, Cucchiari D, Merizzoli E, Elmore U, Angelini C, Badalamenti S. McKittrick-Wheelock syndrome: a rare cause of acute renal failure and hypokalemia not to be overlooked. Ren Fail 2014; 36 (05) 811-813
- 6 Ordieres Díaz C, Pérez Valle I, Fernández de la Varga M. et al. Síndrome de McKittrick-Wheelock: adenoma velloso rectal como causa de insuficiencia renal aguda. Rev Esp Enferm Dig 2022; 114 (04) 245
- 7 Fernández-López F, Paredes-Cotore JP. McKittrick-Wheelock syndrome - Prolapsed giant villous adenoma of the rectum. Rev Esp Enferm Dig 2013; 105 (05) 309-310
- 8 Nakhla SG, Murakami TT, Sundararajan S. Poorly differentiated neuroendocrine tumor of the rectum coexistent with giant rectal villous adenoma presenting as McKittrick-Wheelock syndrome. Case Rep Oncol Med 2015; 2015: 242760