Yoshiji H, Nakae D, Sugiya R, Mizumoto Y, Tsutsumi M, Hiriguchi K, Yokose Y, Sakurai R, Fukui H, Tsujii T
Department of Oncological Pathology, Nara Medical University, Japan.
J Gastroenterol. 1994 Feb;29(1):80-3. doi: 10.1007/BF01229079.
The spontaneous passage of colon cast from a 76-year-old Japanese female patient is reported. Macroscopically, the colon case was shaped like the airbladder of a fish. Histopathologically, the cast consisted of degenerated colonal mucosa, including glands. No inflammatory reaction was apparent. The patient lacked any evidence of abdominal aneurysm. Since there have been only five reported cases of colon cast in the literature, and since in all of those association with abdominal aneurysms was always described, the present study represents the first report demonstrating the formation of a colon cast in the absence of associated abdominal aneurysm. However, the patient was found to exhibit several risk factors for ischemic colitis, such as arteriosclerosis on the wall of the abdominal aorta, chronic constipation, and colonic stenosis. Her colonal mucosal surface, indeed, suggested ischemic colitis. This case report, therefore, indicates that ischemic colitis, due to various causes, may be responsible for the formation of colon casts, and that the presence of an abdominal aneurysm is not necessarily a prerequisite for colon cast formation. This report may contribute to a better understanding of the pathogenesis of colon casts.
本文报告了一位76岁日本女性患者排出结肠铸型的病例。大体上，结肠铸型形似鱼鳔。组织病理学检查显示，铸型由退变的结肠黏膜组成，包括腺体。未见明显炎症反应。患者无腹主动脉瘤的任何证据。鉴于文献中仅报道过5例结肠铸型病例，且所有病例均伴有腹主动脉瘤，本研究是首例报道在无腹主动脉瘤的情况下形成结肠铸型。然而，该患者存在多种缺血性结肠炎的危险因素，如腹主动脉壁动脉硬化、慢性便秘和结肠狭窄。其结肠黏膜表面确实提示有缺血性结肠炎。因此，本病例报告表明，各种原因引起的缺血性结肠炎可能是结肠铸型形成的原因，腹主动脉瘤并非结肠铸型形成的必要前提。本报告可能有助于更好地理解结肠铸型的发病机制。
