Rectal Villous Adenoma with McKittrick-Wheelock Syndrome: Report of a Rare Case

Chen, Yu-Hung; Kang, Jung-Cheng; Lai, Huang-Jen

doi:10.1159/000348494

Cited by 4 publications

(4 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, the numbers are very small, and previous papers have suggested that pharmacological treatments add no benefit beyond appropriate fluid and electrolyte replacement. 20 Based our findings, medical management would definitely be worth considering if a patient is not fit for surgery or chooses not to undergo surgical intervention.…”

Section: Medical Managementmentioning

confidence: 80%

A systematic review of McKittrick–Wheelock syndrome

Orchard

Hooper

Wright

et al. 2018

annals

View full text Add to dashboard Cite

Introduction McKittrick–Wheelock syndrome describes the condition of extreme electrolyte and fluid depletion caused by large distal colorectal tumours, usually the benign villous adenoma. Patients generally present critically unwell with severe hyponatraemia, hypokalaemia and/or acute kidney injury. Methods A structured literature review was undertaken to discover what is known about this condition, which is almost universally described as rare. Important features of the syndrome were identified, including common presenting symptoms, blood results, tumour location and size. Findings Our literature search identified 257 cases reported across all languages. The most remarkable features were the long duration of symptoms (median 24 months) and the significant electrolyte derangements (median sodium of 122mmol/l and median potassium of 2.7mmol/l at initial presentation). Five key recommendations are made to improve diagnosis, including aggressive fluid resuscitation to match rectal losses and surgical intervention on the index admission. The advantages and disadvantages of different treatment options are discussed, including minimally invasive alternatives to traditional resectional surgery. Conclusions McKittrick–Wheelock syndrome describes a normally benign condition that can cause patients to become critically unwell and so it behoves all clinicians to be aware of it. By publishing recommendations based on a comprehensive literature review, we aim to improve diagnosis and management of this life threatening condition.

show abstract

Section: Medical Managementmentioning

confidence: 80%

A systematic review of McKittrick–Wheelock syndrome

Orchard

Hooper

Wright

et al. 2018

annals

View full text Add to dashboard Cite

show abstract

“…Rectal effluent in a case report demonstrated levels 3 to 6 times higher of PGE2 from a villous adenoma [ 9 ]. Hypersecretion can also result in severe azotemia along with electrolyte imbalances that could lead to cardiac arrhythmias and, in severe cases, rhabdomyolysis or altered mental status may be seen [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Poorly Differentiated Neuroendocrine Tumor of the Rectum Coexistent with Giant Rectal Villous Adenoma Presenting as McKittrick-Wheelock Syndrome

Nakhla

Murakami

Sundararajan

2015

Case Reports in Oncological Medicine

View full text Add to dashboard Cite

McKittrick-Wheelock Syndrome is a rare disorder, noted for electrolyte and fluid depletion caused by secretory colorectal adenomas and carcinomas. We report here the first reported case of a 55-year-old man with a large rectal villous adenoma coexistent with a poorly differentiated neuroendocrine tumor of rectum presenting with McKittrick-Wheelock Syndrome. Palliative chemotherapy resulted in complete resolution of symptoms and improved quality of life.

show abstract

“…The larger and more distal the adenoma, the more severe the syndrome. The hypersecretion may be so severe that severe azotemia may result [4].…”

Section: To the Editormentioning

confidence: 99%