Ardigo G J, Longstreth G F, Weston L A, Walker F D
Department of Medicine, Kaiser Permanente Medical Care Program, San Diego, California, USA.
Dis Colon Rectum. 1998 Jun;41(6):793-6. doi: 10.1007/BF02236272.
We report two cases of spontaneous anal passage of a large bowel 'cast' caused by acute ischemic injury.
Clinical, laboratory, endoscopic, and pathologic features were reviewed, and the literature was searched for similar cases.
An 85-year-old male who had undergone aortic surgery recovered from rectosigmoid ischemia after undergoing a descending colostomy. A 74-year-old male with severe pancreatitis developed a postischemic sigmoid stricture but did not have operative treatment before death of pneumonia three months after the episode. A literature review revealed six cases of passage of a large bowel cast. In the eight total patients, infarcted muscularis propria was found in seven specimens, five patients had a diversion procedure, and seven survived.
Passage of a large bowel cast is an extraordinary complication of ischemia that often requires diverting surgery, and most patients survive the ischemic injury.
我们报告两例由急性缺血性损伤导致的大肠“铸型”自肛门排出的病例。
回顾临床、实验室、内镜及病理特征，并检索文献查找类似病例。
一名85岁男性在接受主动脉手术后发生乙状结肠直肠缺血，行降结肠造口术后恢复。一名74岁男性患有严重胰腺炎，出现缺血性乙状结肠狭窄，但在发病三个月后因肺炎死亡前未接受手术治疗。文献回顾发现六例大肠铸型排出病例。在总共八名患者中，七个标本中发现固有肌层梗死，五名患者接受了转流手术，七名患者存活。
大肠铸型排出是缺血的一种罕见并发症，通常需要进行转流手术，且大多数患者能从缺血性损伤中存活。
