Popescu Alina, Orban-Schiopu Ana-Maria, Becheanu Gabriel, Diculescu Mircea
Gastroenterology, Hepatology and Endoscopy Clinic of the Elias Hospital, Bd. Marasti 17, Bucharest, Romania.
Rom J Gastroenterol. 2005 Mar;14(1):63-6.
Fluid and electrolyte hypersecretion in the villous adenoma of the rectum is presented in the case of a 74 year old man presenting with a severe fluid imbalance.
The patient had a 2-year history of mucous diarrhea and, on admission, presented prerenal uremia, hyponatremia and severe hypokalemia. At sigmoidoscopy, a 6/4 cm villous adenoma of the rectum was found. The increased loss of volume, followed by exhaustion of the physiological compensation mechanisms, led to a life-threatening hypokalemia, as well as to acute renal failure. Conservative treatment was followed by a temporary improvement of the renal function. Alternative treatment was: endocavitary irradiation, endoscopic resection and radical tumor surgery. The surgical removal of the adenoma led to complete recovery of the symptoms.
The McKittrick-Wheelock syndrome can be a problem of difficult diagnosis, both for the gastroenterologist and also for the nephrologist. The patient may develop severe complications, which require a sustained treatment.
本文报告了一名74岁男性患者，因严重的液体失衡出现直肠绒毛状腺瘤的液体和电解质分泌过多情况。
该患者有2年黏液性腹泻病史，入院时出现肾前性尿毒症、低钠血症和严重低钾血症。在乙状结肠镜检查中，发现一个6/4厘米的直肠绒毛状腺瘤。液体丢失增加，随后生理代偿机制耗尽，导致危及生命的低钾血症以及急性肾衰竭。保守治疗后肾功能有暂时改善。替代治疗方法包括：腔内照射、内镜切除和根治性肿瘤手术。腺瘤的手术切除使症状完全缓解。
麦基特里克-惠洛克综合征对胃肠病学家和肾病学家来说都可能是一个诊断难题。患者可能会出现严重并发症，需要持续治疗。
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