Metabolic abnormality is seen in large colorectal villous adenoma

Villous adenomas causing profuse watery diarrhoea and hypokalemia is known as the McKittrick Wheelock syndrome after it was first described in 1954. Metabolic abnormalities seen are hyponatraemia, hypokalaemic, and hypochloraemic metabolic acidosis. Severe volume loss may cause acute renal failure and cardiovascular collapse. The mechanism of fluid and electrolyte loss is unclear. Locally released prostaglandin E2 has been suggested as the secretagogue responsible for salt wasting, as has a cyclic AMP. Treatment: Reversal of the biochemical derangement is the cornerstone of successful management. Once resuscitated, immediate surgical resection of the tumor, is the treatment of choice.