Erguney Sabri, Yavuz Nihat, Ersoy Yeliz E, Teksoz Serkan, Selcuk Dogan, Ogut Gunduz, Dogusoy Gulen, Alver Olcay
General Surgery Department, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
J Gastrointest Surg. 2007 Aug;11(8):1045-51. doi: 10.1007/s11605-007-0194-z. Epub 2007 Jun 13.
Anal passage of a full-thickness infarcted colonic segment (so-called "cast") not accompanied by any features of acute peritonitis is a very rare occurrence and may be the main advertising manifestation of acute colonic ischemia. Most of the reported cases of acute colonic ischemia are secondary to abdominal aortic aneurysms and ensuing inferior mesenteric artery thrombosis or to the repair of these aneurysms. The preceding events causing ischemia in other cases are Hartmann reversal, rectal resection and colonic J-pouch construction, and acute pancreatitis. In this article we present our experience on four cases of colonic cast passage, all of which developed subsequent to colorectal resection. Three of these casts are supposed to be mucosal and one is transmural. Generally, surgery is the rule and consists of the resection of the concerned ischemic segment. Every clinician should be aware of this form of presentation of bowel ischemia, not only following aneurysm surgery but also in the postoperative course of colorectal surgery.
全层梗死结肠段经肛门排出（所谓的“铸型”）且不伴有任何急性腹膜炎特征的情况极为罕见，可能是急性结肠缺血的主要表现。大多数报道的急性结肠缺血病例继发于腹主动脉瘤及随后的肠系膜下动脉血栓形成，或继发于这些动脉瘤的修复。其他病例中导致缺血的先前事件包括哈特曼翻转术、直肠切除术和结肠J袋构建以及急性胰腺炎。在本文中，我们介绍了4例结肠铸型排出的经验，所有这些病例均发生在结直肠切除术后。其中3个铸型被认为是黏膜性的，1个是透壁性的。一般来说，手术是常规治疗方法，包括切除相关的缺血段。每位临床医生不仅在动脉瘤手术后，而且在结直肠手术后的病程中，都应意识到这种肠道缺血的表现形式。
