title: The McKittrick-Wheelock syndrome: a rare cause of chronic diarrhoea.
abstract: The McKittrick-Wheelock syndrome, a rare disorder, is caused by fluid and electrolyte hypersecretion from a rectal tumour and patients can develop a depletion syndrome characterised by severe dehydration, hyponatraemia, hypokalaemia and metabolic acidosis. We present a case of a 62-year-old man who presented with chronic diarrhoea that had resulted in numerous previous hospital admissions. On physical exam, the patient showed signs of volume depletion. A soft polypoid mass was appreciated on digital rectal examination. Laboratory tests showed renal failure and significant electrolyte abnormalities. Colonoscopy revealed a large, friable mass in the rectosigmoid region. Biopsies were consistent with tubolovillous adenoma. Subsequently, the patient underwent surgical resection, which on pathology exhibited evidence of high-grade dysplasia, and the patient was diagnosed with McKittrick-Wheelock syndrome. It is essential to identify this condition in a timely manner as it is associated with high morbidity and complications, some of which may be life threatening.
authors.affiliation: Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Jana G
authors.initials: JG
authors.lastname: Hashash
authors.forename: Jennifer
authors.initials: J
authors.lastname: Holder-Murray
authors.forename: Elie
authors.initials: E
authors.lastname: Aoun
authors.forename: Dhiraj
authors.initials: D
authors.lastname: Yadav
mesh_terms: D018253:Adenoma, Villous / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D002908:Chronic Disease; D003681:Dehydration / Q000175:diagnosis; D003967:Diarrhea / Q000209:etiology*; D006801:Humans; D007008:Hypokalemia / Q000175:diagnosis; D007010:Hyponatremia / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D013577:Syndrome; D014883:Water-Electrolyte Imbalance / Q000175:diagnosis