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DOI: 10.1055/a-2590-8284
Organ-preserving endoscopic resection of a large colorectal lesion causing McKittrick–Wheelock syndrome
McKittrick–Wheelock syndrome is a rare but life-threatening condition characterised by severe diarrhoea, electrolyte disturbances, and kidney injury caused by colorectal tumours [1]. The majority of reported cases have been managed by surgical resection [2]. We demonstrate a case of McKittrick–Wheelock syndrome managed endoscopically by speedboat-assisted endoscopic submucosal dissection (S-ESD). S-ESD involves the use of a novel endoscopic electrosurgical device combining advanced bipolar radiofrequency for dissection and microwave energy for coagulation ([Video 1]). This technique was selected to enable en-bloc resection with the potential for organ preservation, while minimising the risks associated with surgery below the peritoneal reflection, particularly in an elderly patient with multiple co-morbidities.
Speedboat-assisted endoscopic submucosal dissection (S-ESD) of a large colorectal lesion causing McKittrick–Wheelock syndrome.Video 1The lesion was removed en-bloc completely by S-ESD ([Fig. 1]). Our patient had an uneventful recovery without any immediate or delayed complications. Histology confirmed R0 resection of a tubulovillous adenoma with low-grade dysplasia and focal high-grade dysplasia. S-ESD using Speedboat is a safe alternative to surgery for the management of McKittrick–Wheelock syndrome especially with lesions below the peritoneal reflection to minimise complications associated with surgery.
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Publication History
Article published online:
22 May 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).
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References
- 1 Hashash JG, Holder-Murray J, Aoun E. et al. The McKittrick-Wheelock syndrome: a rare cause of chronic diarrhoea. BMJ Case Rep 2013;
- 2 Orchard MR, Hooper J, Wright JA. et al. A systematic review of McKittrick-Wheelock syndrome. Ann R Coll Surg Engl 2018; 100: 1-7