McKittrick-Wheelock Syndrome Treated by Laparoscopy

Abstract

When colonoscopic resection is not feasible in cases of secreting villous adenomas owing to their size or location, laparoscopic surgery in expert hands is a safe, effective, and complete option, further enhanced by the benefits of minimally invasion surgery.

Electrolyte depletion syndrome (McKittrick–Wheelock syndrome) successfully treated by endoscopic submucosal dissection

“…The mechanism behind these symptoms is suggested to involve cyclic adenosine monophosphate (AMP) and prostaglandin E2 acting as mediators, which increase the loss of fluid and electrolytes from plasma to the intestinal lumen [14]. Endoscopic findings of tumors that cause MWS indicate that they are large, villous and mucus-rich [2,3,10,12,13,15,16], which we saw in the present case. Villous tumors are characterized by a structure of finger-like projections composed of loose vascular connective tissues covered by a single layer of columnar epithelial cells.…”

“…Tumors that develop MWS are usually large but mostly benign villous adenomas [3,[10][11][12], and advanced cancer cases are seldom reported [13]. Therefore, the indication of ESD for MWS is a good alternative strategy to surgery.…”

“…Partial colectomy performed surgically is the current standard treatment for McKittrick-Wheelock syndrome (MWS) [2,3]. However, its invasiveness and postoperative complications are sometimes problematic [4,5].…”

Malignant McKittrick-Wheelock syndrome as a cause of acute kidney injury and hypokalemia: Report of a case and review of literature

“…Of seven patients with bleeding, only two patients had underlying malignancy while five had rectal villous adenoma. Renal failure was found to be present in 30 out of 35 reported cases at presentation with 3 patients not having renal injury and data was not available for 2 patients (15)(16)(17). The mean blood urea nitrogen and creatinine values at presentation were 106.1 ± 60 mg/dL and 5.1 ± 2.96 mg/dL respectively.…”

A case of rectal villous adenoma in a female patient presenting with chronic diarrhea and acute renal failure

“…First described in 1954 McKittrick-Wheelock syndrome a triad of and electrolyte depletion, Dehydration, mucous diarrhea cause by a secretory colorectal adenoma or adenoncarcinoma [1] presenting with symptoms of hyponatremia ranging from gastrointestinal upset up to seizures and coma, hypokalemia with fatique and ileus up to cardiac dysfunction and arrythmias and hypotension [2][3][4][5]. Current management strategies include prompt and aggressive fluid and electrolyte replacement till normalization of kidney functions and improvement of general condition thus preventing the often-grave complications of this hydroelectrolytic imbalance on organs followed by immediate curative surgical resection or endoscopic resection of the colorectal mass depending on the characteristics of the mass that include size, site and accessibility [6][7][8].…”