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CC BY-NC-ND 4.0 · Journal of Coloproctology 2022; 42(02): 187-189
DOI: 10.1055/s-0041-1742255
Case Report

McKittrick-Wheelock Syndrome Secondary to Rectal Adenocarcinoma

Bruno Augusto Alves Martins 
1   Serviço de Coloproctologia, Hospital Universitário de Brasília, Brasília, DF, Brazil
,
Ana Clara Ramalho Gomes 
2   Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil
,
Maria Eduarda de Almeida Santos 
2   Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil
,
Natascha Mourão Moreira 
1   Serviço de Coloproctologia, Hospital Universitário de Brasília, Brasília, DF, Brazil
,
Romulo Medeiros de Almeida 
1   Serviço de Coloproctologia, Hospital Universitário de Brasília, Brasília, DF, Brazil
2   Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil
,
João Batista de Sousa 
1   Serviço de Coloproctologia, Hospital Universitário de Brasília, Brasília, DF, Brazil
2   Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil
› Author Affiliations Funding statement The present research did not receive any specific grants from funding agencies in the public, commercial, or nonprofit sectors.
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Abstract

Introduction McKittrick-Wheelock syndrome is a rare condition that arises from a hypersecretory state secondary to large colorectal tumors, mainly villous adenomas, leading to an electrolytic disorder associated with chronic diarrhea that usually persists for years. It is a relatively unknown disease that can lead to severe complications such as acute kidney injury, severe hyponatremia, and hypokalemia. In fact, it causes death in most untreated cases. Surgical removal of the tumor is the most successful treatment, and symptoms tend to disappear after proper management.

Case Report A 62-year-old man with a 2-year history of mucoid diarrhea preceded by abdominal pain presented with acute kidney injury, hyponatremia, and hypokalemia. A digital rectal examination and sigmoidoscopy were performed, and revealed a large laterally-spreading tumor in the rectum. Further investigation showed a rectal tubulovillous adenoma with secondary McKittrick-Wheelock syndrome. An anterior resection of the rectum with a colonic J-pouch and a diverting ileostomy were performed, and the patient improved with the resolution of the renal failure and electrolyte disturbances. The histopathological analysis revealed an invasive rectal adenocarcinoma.

Discussion McKittrick-Wheelock syndrome is a condition with a low incidence that needs early intervention and proper diagnosis. It is of extreme importance that this disease is included in the differential diagnoses for chronic diarrhea associated with an electrolytic disorder.

Keywords

colorectal neoplasms - colorectal surgery - syndromes - acute kidney injury - electrolyte disturbance - chronic diarrhea


Publication History

Received: 05 August 2021

Accepted: 25 October 2021

Article published online:
15 June 2022

© 2022. 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 commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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