Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania.
Clinic of Gastroenterology, Nephrourology, and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania.
Medicina (Kaunas). 2023 Mar 22;59(3):633. doi: 10.3390/medicina59030633.
An adenoma is the most typical large bowel tumor found in 30% of all screening colonoscopies. However, it is often asymptomatic but sometimes might lead to abdominal pain or bleeding of the rectum. Critical electrolyte disbalance and acute kidney injury caused by secretory diarrhea is an untypical clinical manifestation of adenoma. It has rarely been reported in the literature and is defined as McKittrick-Wheelock syndrome. A 61-year-old patient was hospitalized for heavy dyselectrolytemia, diarrhea, acute kidney injury, sepsis, and fever. After the renal function was corrected and electrolyte imbalance persisted, visual instrumental diagnostics tests revealed a large tumor in the sigmoid colon. Subsequently, the patient underwent surgical resection, which exhibited evidence of tubulovillous adenoma on pathology. The atypical signs of McKittrick-Wheelock syndrome and comorbidities can make the diagnostics challenging. When severe hyponatremia and hypokalemia are followed by persistent mucous diarrhea, the clinicians should suspect MWS as a possible reason for it.
腺瘤是在所有筛查结肠镜检查中发现的最典型的大肠肿瘤，占 30%。然而，它通常没有症状，但有时可能导致腹痛或直肠出血。由分泌性腹泻引起的严重电解质失衡和急性肾损伤是腺瘤的一种非典型临床表现。它在文献中很少被报道，被定义为 McKittrick-Wheelock 综合征。一名 61 岁的患者因严重电解质紊乱、腹泻、急性肾损伤、脓毒症和发热住院。肾功能纠正后，电解质失衡仍持续存在，视觉仪器诊断检查显示乙状结肠有一个大肿瘤。随后，患者接受了手术切除，病理显示为管状绒毛状腺瘤。McKittrick-Wheelock 综合征的非典型体征和合并症可能使诊断具有挑战性。当严重低钠血症和低钾血症后持续出现粘液性腹泻时，临床医生应怀疑 MWS 是可能的原因。
