Chronic Diarrhea with Renal Insufficiency and Electrolyte Disturbances due to a Large Rectal Polyp

About 3% of all villous adenomas have a hypersecretory activity [1]. Proportional to the size, these secretory polyps can produce an abundant amount of rectal discharge and consequentially can cause hypovolemia, renal insufficiency and profound electrolyte disturbances. This rare disorder is known as the McKittrick-Wheelock syndrome (MWS) [1-10]. Treatment is initially based on volume resuscitation and on correction of the electrolyte disturbances. Definitive treatment consists of endoscopic and/or surgical resection of the villous adenoma. In this article, we present a case of the MWS caused by a large rectal villous adenoma that was successfully treated by endoscopic resection. We review previously published reports to get a deeper insight into the pathophysiological mechanisms of MWS.