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
