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2016 ; 98
(7
): e109-10
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Colonic casts: unexpected complications of colonic ischaemia
#MMPMID27241609
Mantas D
; Damaskos C
; Bamias G
; Dimitroulis D
Ann R Coll Surg Engl
2016[Sep]; 98
(7
): e109-10
PMID27241609
show ga
Introduction Extensive colonic ischaemia can result in passage of a colonic
'cast' (CC) through the rectum. Case Study We report a 69-year-old male who
initially underwent surgery to remove a sessile polyp. On postoperative day
(POD)15, he was febrile, suffering from diarrhoea, and was treated
conservatively. On POD18, the patient returned to our hospital with a CC that
presented after defaecation. Computed tomography of the abdomen revealed a CC
extending from the descending colon to the anal orifice with presentation of air
between the affected colonic wall and the CC. The patient was treated
conservatively and discharged on POD20 without complications having passed the CC
(?80cm) completely and becoming afebrile. Conclusions In most cases, the cause of
CC passage is surgery for colorectal cancer or repair of an abdominal aortic
aneurysm. A mild-to-severe presentation is dependent upon the bowel-wall layers
affected by ischaemia and which therefore are included in the CC.