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. (AU)