Abstract
The McKittrick-Wheelock syndrome is characterized by severe electrolyte and fluid depletion as a result of rectal tumor hypersecretion. Typically, a metabolic acidosis ensues. We report the case of a 58-year-old man who presented with a mixed metabolic acidosis and alkalosis. He was hyponatremic, hypokalemic, and hypochloremic, with acute renal failure on blood testing. Following fluid resuscitation, a predominant alkalemia was observed. The patient was found to be passing 1.5 L of mucous per rectum per day, containing high concentrations of sodium and potassium, similar to that observed in cholera stool. A large rectal villous adenoma was discovered on sigmoidoscopy, and definitive management was achieved by removal of the tumor. This case provides a demonstration of the ranging metabolic disturbance associated with secretory diarrhea. Other endogenous and infective causes are discussed, and mechanisms compared with the case described.
Original language | English |
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Pages (from-to) | 469-473 |
Number of pages | 5 |
Journal | Renal Failure |
Volume | 30 |
Issue number | 4 |
DOIs | |
Publication status | Published - 1 May 2008 |
Keywords
- cholera
- villous adenoma
- metabolic alkalosis
- delta anion gap
- McKittrick-Wheelock syndrome