title: [Acute renal failure and chronic diarrhea: McKittrick-Wheelock syndrome].
abstract: In 1954, McKittrick and Wheelock described for the first time a syndrome presenting chronic lost of fluid and electrolytes secondary to chronic diarrhea, associated to large rectal villous adenomas. We report a case of a 75-year-old female who presented chronic diarrhea (3 to 4 depositions per day in the last year), accompanied by acute renal failure. In the rectal tact, we objective the presence of a mass of soft consistency with an irregular surface, occupying approximately two thirds of the circumference, at about 3 cm from the anal margin. It was confirmed by the colonoscopy and the patology was informed as villous adenoma, producing chronic diarrhea or McKittrick-Wheelock syndrome. We decide the surgical approach after the normalization of patient's general status and a proctectomy with coloanal anastomosis was performed. We conclude that we must think about this syndrome in aged patients with chronic diarrhea, alterations of the electrolyte balance and presence of renal failure. Surgery treatment after the replacement of water and electrolytes is the unique curative treatment. The absence of this can cause the death of these patients.
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario de Elche, Alicante, España. pedromoyaforcen@gmail.com
authors.forename: Pedro
authors.initials: P
authors.lastname: Moya
authors.forename: Laura
authors.initials: L
authors.lastname: Armañanzas Ruiz
authors.forename: Jair
authors.initials: J
authors.lastname: Santos Torres
authors.forename: Fernando
authors.initials: F
authors.lastname: Candela Polo
authors.forename: Juan
authors.initials: J
authors.lastname: Perez-Legaz
authors.forename: Antonio
authors.initials: A
authors.lastname: Arroyo
authors.forename: Rafael
authors.initials: R
authors.lastname: Calpena Rico
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000601:surgery; D018253:Adenoma, Villous / Q000150:complications* / Q000601:surgery; D000368:Aged; D003110:Colonic Neoplasms / Q000150:complications* / Q000601:surgery; D003113:Colonoscopy; D003967:Diarrhea / Q000209:etiology*; D005260:Female; D006801:Humans; D013577:Syndrome; D014883:Water-Electrolyte Imbalance / Q000209:etiology* / Q000628:therapy