Villous Adenoma of the Rectum Associated with Electrolyte Disturbance*

Eisenberg, Herman; Kolb, Leonard H.; Yam, Lung T.; Godt, R. E.

doi:10.1097/00000658-196404000-00021

Cited by 11 publications

(5 citation statements)

References 13 publications

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“…Villous adenomatous polyps underlying McKittrick-Wheelock syndrome are generally benign, with 15-25% malignant potential, which is even higher (about 40%) for polyps over 4 cm in diameter. Although up to twothirds of polyps are found in the rectum, they can also be identified in the recto-sigmoid, cecum, ascending colon, stomach or duodenum [7].…”

Section: Discussionmentioning

confidence: 99%

“…Large villous adenomas of the rectum or recto-sigmoid can rarely cause secretory mucinous diarrhea, characterized by massive fluid loss, acute renal failure and electrolyte depletion, due to the distal location of the tumor that does not allow adequate reabsorption [7,8]. Adenoma must measure between 7-18 cm in diameter and cover a large percentage of the mucosal surface of the rectum or colon in order to determine significant volume loss [9,10].…”

Section: Discussionmentioning

confidence: 99%

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Uncommon Association of Mckittrick-Wheelock Syndrome and Clostridioides difficile Infection in Acute Renal Failure

et al. 2022

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We present the case of a 71-year-old male who suffered an episode of acute renal failure caused by the uncommon association of two different diseases (Clostridioides difficile infection and McKittrick-Wheelock syndrome). He presented with hypovolemic shock, severe hypokalemia, hyponatremia, metabolic acidosis and acute renal failure; consequences of secretory diarrhea caused by a giant rectal tumor revealed from colonoscopy. The biopsy results revealed tubulo-villous adenoma with low/high grade dysplasia. After correction of electrolyte imbalances and azotemia, the patient underwent surgical resection with full subsequent recovery. In the literature review, including papers published from which January 1945 to April 2021, we found only one case-report of acute renal failure associated with Clostridioides difficile infection and McKittrick-Wheelock syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Uncommon Association of Mckittrick-Wheelock Syndrome and Clostridioides difficile Infection in Acute Renal Failure

et al. 2022

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“…Rarely, large villous adenomas of the rectum or rectosigmoid cause secretory mucinous diarrhoea characterised by massive fluid loss, acute renal failure and electrolyte depletion due to the secretory capacity of the tumour coupled with minimal absorptive capacity of normal colonic mucosal due to reduced surface area distal to the adenoma. Hyperglycaemia and diabetes are rare manifestations of MWS, and to date, few cases of MWS in association with new-onset diabetes have been reported ( 4 , 5 , 6 ). In these reports, however, ascertaining whether hyperglycaemia was truly a manifestation of MWS is complicated by administration of high-dose glucocorticoids to affected subjects for possible adrenal insufficiency before hyperglycaemia was recognised.…”

Section: Discussionmentioning

confidence: 99%

The McKittrick–Wheelock syndrome: a rare cause of curable diabetes

Challis

Lim

Cluroe

et al. 2016

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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SummaryMcKittrick–Wheelock syndrome (MWS) is a rare consequence of severe dehydration and electrolyte depletion due to mucinous diarrhoea secondary to a rectosigmoid villous adenoma. Reported cases of MWS commonly describe hypersecretion of mucinous diarrhoea in association with dehydration, hypokalaemia, hyponatraemia, hypochloraemia and pre-renal azotemia. Hyperglycaemia and diabetes are rarely reported manifestations of MWS. Herein we describe the case of a 59-year-old woman who presented with new-onset diabetes and severe electrolyte derangement due to a giant rectal villous adenoma. Subsequent endoscopic resection of the tumour cured her diabetes and normalised electrolytes. This case describes a rare cause of ‘curable diabetes’ and indicates hyperaldosteronism and/or whole-body potassium stores as important regulators of insulin secretion and glucose homeostasis.Learning pointsMcKittrick–Wheelock syndrome (MWS) is typically characterised by the triad of pre-renal failure, electrolyte derangement and chronic diarrhoea resulting from a secretory colonic neoplasm.Hyperglycaemia and new-onset diabetes are rare clinical manifestations of MWS.Hyperaldosteronism and/or hypokalaemia may worsen glucose tolerance in MWS.Aggressive replacement of fluid and electrolytes is the mainstay of acute management, with definitive treatment and complete reversal of the metabolic abnormalities being achieved by endoscopic or surgical resection of the neoplasm.

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“…Villous adenomas are mostly located below the peritoneal reflection (79% in the rectosigmoid or distal to it). Rarely, they may be found as high as the hepatic flexure [ 7 ]. On barium enema, they appear soft and produce sessile filling defects with irregular mucosal patterns known as reticular, granular, lacy, or feathery.…”

Section: Discussionmentioning

confidence: 99%

Apple-core lesion of the colon: a case report

Alzaraa

Krzysztof

Uwechue

et al. 2009

Cases J

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IntroductionThe appearance of the apple-core lesion of the colon can be caused by several diseases.Case presentationA male patient was referred to the surgical clinic with melaena and weight loss. Clinical examination and investigations confirmed an apple-core lesion of the colon. He underwent surgery, but unfortunately, died of a chest infection two weeks after the operation.ConclusionThis case shows the use of computed tomography in demonstrating the primary cause of iron deficiency anaemia, and at the same time, staging the disease for loco-regional metastasis.

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Villous Adenoma of the Rectum Associated with Electrolyte Disturbance*

Cited by 11 publications

References 13 publications

Uncommon Association of Mckittrick-Wheelock Syndrome and Clostridioides difficile Infection in Acute Renal Failure

Uncommon Association of Mckittrick-Wheelock Syndrome and Clostridioides difficile Infection in Acute Renal Failure

The McKittrick–Wheelock syndrome: a rare cause of curable diabetes

Apple-core lesion of the colon: a case report

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