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直肠肿瘤性息肉导致的肾衰竭:麦基特里克-惠洛克综合征——一例报告

Renal failure due to rectal neoplastic polyp: McKittrick-Wheelock syndrome-a case report.

作者信息

Dimitrov Ivan Valentinov, Sedloev Theophil Angelov, Vasilev Ivan Petrov, Usheva Slavyana Slavcheva, Nikolov Yavor Asenov, Penkov Nikolay Metodiev, Penchev Plamen Ivanov, Boyadzhieva Maria-Elena, Jelev Georgi Chavdarov

机构信息

Department of Surgery, University Hospital "Tsaritsa Joanna - ISUL", Medical University, Str. "Byalo More" No 8, Sofia, Bulgaria.

Department of Gastroenterology, University Hospital "Tsaritsa Joanna - ISUL", Medical University, Sofia, Bulgaria.

出版信息

J Med Case Rep. 2025 Jan 6;19(1):3. doi: 10.1186/s13256-024-05013-0.

Abstract

BACKGROUND

McKittrick-Wheelock syndrome is an uncommon and severe disorder caused by large hypersecretory tumors located in the distal colorectal area. Excessive secretion from adenomas is an unusual clinical manifestation that leads to severe electrolyte and fluid depletion, subsequently resulting in kidney injury. Successful treatment relies on quick and cooperative decision-making for timely intervention.

CASE PRESENTATION

A 79-year-old Bulgarian male patient was admitted to the emergency department with syncope resulting from severe electrolyte depletion and renal failure caused by excessive secretion from a rectal polyp. The initial diagnostic and treatment journey included computed tomography, rectoscopy, biopsy, and an attempt at piecemeal removal, ultimately leading to abdominoperineal resection. Despite the permanent colostomy, the patient experienced a smooth recovery and significant improvement in his quality of life.

CONCLUSION

McKittrick-Wheelock syndrome begins with nonspecific initial symptoms in the first extended latent phase, mainly diarrhea, followed by a brief deterioration phase and decompensation phase. However, the key to restoring renal function and correcting electrolyte imbalances lies in surgically removing the tumor, making early detection crucial. Employing a multidisciplinary strategy that includes prompt recognition, timely intervention, and thorough preoperative stabilization is crucial for achieving successful outcomes.

摘要

背景

麦基特里克 - 惠洛克综合征是一种由位于结直肠远端的大量分泌过多的肿瘤引起的罕见且严重的疾病。腺瘤过度分泌是一种不寻常的临床表现,会导致严重的电解质和液体消耗,进而导致肾损伤。成功的治疗依赖于快速且协同的决策以便及时干预。

病例介绍

一名79岁的保加利亚男性患者因直肠息肉过度分泌导致严重电解质耗竭和肾衰竭而晕厥,被收入急诊科。最初的诊断和治疗过程包括计算机断层扫描、直肠镜检查、活检以及尝试分块切除,最终进行了腹会阴切除术。尽管进行了永久性结肠造口术,但患者恢复顺利,生活质量有显著改善。

结论

麦基特里克 - 惠洛克综合征在第一个较长的潜伏期开始时表现为非特异性初始症状,主要是腹泻,随后是短暂的恶化期和失代偿期。然而,恢复肾功能和纠正电解质失衡的关键在于手术切除肿瘤,因此早期检测至关重要。采用包括迅速识别、及时干预和全面术前稳定在内的多学科策略对于取得成功结果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ce2/11705777/87fb89050477/13256_2024_5013_Fig1_HTML.jpg

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