Boyer DE, Alfeiran RA, Montes De Oca OCR, Flores PFJ, Ortiz MTI, Estradas TJA, Rodríguez GA, Muñoz AE

Language: Spanish
References: 16
Page: 357-360
PDF size: 169.61 Kb.

ABSTRACT

Introduction: The Mckittrick-Wheelock syndrome is characterized by hydroelectrolytic depletion, secondary to hypersecretory diarrhea due to a large villous adenoma of the rectum. Its cause is postulated by hypersecretion of prostaglandin E2. The adenoma occurs most frequently in the rectum. Case report: A 60-year-old male with chronic diarrheal, one year of evolution, with multiple tratments, underwent a left hemicolectomy due to the finding of a serrated adenoma of the rectum. Conclusions: The condition is characterized by diarrhea and severe dehydration; treatment with indomenthacin has been tried to decrease the secretion of prostaglandin E2, being the definitive treatment, surgery.

REFERENCES

1. Martínez GR, Segundo GA, Trullenque JR, Martínez ME, Mártinez AM. Síndrome de McKittrick-Wheelock: adenoma de recto gigante secretor. Cir Esp. 2010; 87 (2): 114-126.

2. Mois E, Graur F, Sechel R, Al-Hajjar N. Mckittrick-Wheelock syndrome a rare case report of acute renal failure. Clujul Medical. 2016; (2): 301-303.

3. Steven K, Lange P, Bukhave K et al. Prostaglandin E2-mediated secretory diarrhea in villous adenoma of rectum: effect of treatment with indomethacin. Gastroenterology. 1981; 80: 1562-1566.

4. O’Brien MJ, Winawer SJ, Zauber AG et al. The National Polyp Study. Patient and polyp characteristics associated with high-grade dysplasia in colorectal adenomas. Gastroenterology. 1990; 98: 371-379.

5. Tuta L, Bosoteanu M, Deacu M et al. McKittrick–Wheelock syndrome: a rare etiology of acute renal failure associated to well-differentiated adenocarcinoma (G1) arising within a villous adenoma. Rom J Morphol Embryol. 2011; 52 (3 Suppl): 1153-1156.

6. Popescu A, Orban-Schiopu AM, Becheanu G, Diculescu M. McKittrick-Wheelock syndrome - a rare cause of acute renal failure. Rom J Gastroenterol. 2005; 14 (1): 63-66.

7. Mila R, Grille S, Laurini M, Lapiedra D. Síndrome de McKittrick-Wheelock: una causa infrecuente de shock hipovolémico. Rev Méd Chile. 2008; 136: 900-904.

8. McKittick LS, Wheelock FC. Carcinoma of the colon. Springfield, III: Charles C Thomas Publisher 1954, p. 61.

9. Fearon ER, Vogelstein B. A genetic model for colorectal tumorigenesis. Cell. 1990; 61 (5): 759-767.

10. Jass JR. Classification of colorrectal cancer based on correlation of clinical, morphological and molecular features. Histopathology. 2007; 50: 113-130.

11. Gurudu SR, Heigh RI, De Petris G, Heigh EG, Leighton JA, Pasha SF et al. Sessile serrated adenomas: Demographic, endoscopic and pathological characteristics. World J Gastroenterol. 2010; 16 (27): 3402-3405.

12. Yamada A, Notohara K, Aoyama I, Mishoshi M, Miyamoto S, Fujii S et al. Endoscopic features of sessile serrated adenoma and other serrated colorectal polyps. Hepatogastroenterology. 2011; 58 (105): 45-51.

13. Hiraoka S, Kato J, Fujiki S, Kaji E, Morikawa T, Murakami T et al. The presence of large serrated polyps increases risk for colorectal cancer. Gastroenterology. 2010; 139 (5): 1503-1510.

14. Yano Y, Konishi K, Yamochi T, Katagiri A, Nozawa H, Susuki H et al. Clinicopathological and molecular features of colorectal serrated neoplasias with different mucosal crypt patterns. Am J Gastroenterol. 2011; 106 (7): 1351-1358.

15. Spring KJ, Zhao ZZ, Karamatic R, Walsh MD, Whitehall VL, Pike T et al. High prevalence of sessile serrated adenomas with BRAF mutations: a prospective study of patients undergoing colonoscopy. Gastroenterology. 2006; 131: 1400-1407.

16. Winawer SJ, Zauber AG, Fletcher RH, Stillman JS, O’Brien MJ, Levin B et al. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. Gastroenterology. 2006; 130: 1872-1885.