EP 377 McKittrick-Wheelock Syndrome – The Rectal Polyp and Renal Failure A Case Report

Abstract

Case Report:

Aims: A 71 year old female presented with malaise and one week history of diarrhoea. She was found to have acute renal failure thought secondary to electrolyte loses. She subsequently underwent imaging, colonoscopy, and subsequent Trans--Anal-Minimally Invasive Surgery (TAMIS) to excise a rectal polyp. This rare constellation of symptoms is described as McKittrick-Wheelock syndrome. Left untreated, it carries a significant associated mortality. This case report aims to increase awareness of the syndrome and hope this case helps aid further series reviews of the condition in an attempt to optimise its management for future patients.

Methods: We will summarise how the rare diagnosis was reached, the patient's journey subsequent management which and follow up management of the patient as well as reviewing current literature regarding this syndrome.

Conclusion: Mckittrick Wheeler syndrome is a rare presentation which some clinicians may never encounter we review literature regarding optimal treatment and how this correlated to our patients journey as well as several take away/ learning points.

This syndrome often manifests as three distinct periods of electrolyte disturbance, the last of which is decompensation. This phase leads to deterioration in renal function and electrolyte abnormality which usually leads to emergency presentation. We advise Ensuring renal function has been checked recently in the patient with a large rectal polyp to avoid patient’s with Mckittrick-Wheeler syndrome presenting in the decompensatory phase even in the patient setting.