A systematic review of McKittrick–Wheelock syndrome
Publication in refereed journal


摘要INTRODUCTION McKittrick–Wheelock syndrome describes the condition of extreme electrolyte and fluid depletion caused by large distal colorectal tumours, usually the benign villous adenoma. Patients generally present critically unwell with severe hyponatraemia, hypokalaemia and/or acute kidney injury.
METHODS A structured literature review was undertaken to discover what is known about this condition, which is almost universally described as rare. Important features of the syndrome were identified, including common presenting symptoms, blood results, tumour location and size.
FINDINGS Our literature search identified 257 cases reported across all languages. The most remarkable features were the long duration of symptoms (median 24 months) and the significant electrolyte derangements (median sodium of 122mmol/l and median potassium of 2.7mmol/l at initial presentation). Five key recommendations are made to improve diagnosis, including aggressive fluid resuscitation to match rectal losses and surgical intervention on the index admission. The advantages and disadvantages of different treatment options are discussed, including minimally invasive alternatives to traditional resectional surgery.
CONCLUSIONS McKittrick–Wheelock syndrome is a usually benign condition that can cause patients to become critically unwell and so it behoves all clinicians to be aware of it. By publishing recommendations based on a full literature review, we aim to improve diagnosis and management of this life threatening condition.
著者M.R. Orchard, J. Hooper, J.A. Wright, K. McCarthy
期刊名稱Annals of The Royal College of Surgeons of England
頁次591 - 597
關鍵詞Rectal tumour, Water–electrolyte imbalance

上次更新時間 2021-13-10 於 23:42