Colonic cast

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Colonic cast
Diagnosis in short

Colonic cast. H&E stain. (WC)

LM ischemic colorectal wall (ghost-like crypts without nuclei, muscle without nuclei), mild inflammation
LM DDx infectious colitis
Gross membranous material, fish bladder-like
Site colon

Associated Dx ischemic colitis, atherosclerosis
Clinical history typically post-AAA repair or after colorectal surgery
Prevalence rare
Prognosis benign
Clin. DDx fecal material
Treatment see ischemic colitis

Colonic cast, also colon cast, is a soughed off fragment of colonic wall due to colonic ischemia.

General

Gross

  • Membranous appearance; described as airbladder of fish-like.[3]

DDx:

Images

Microscopic

Features:

  • Ischemic colorectal wall.

Images

IHC

  • AE1/AE3, desmin - may be useful to delineate the morphology.

Sign out

Submitted as "Colonic Cast":
- Compatible with colorectal cast (necrotic partial colorectal wall 
  with identifiable mucosa and submucosa).
- NEGATIVE for malignancy.

See also

References

  1. Abe, S.; Yamaguchi, H.; Murono, K.; Kanazawa, T.; Ishihara, S.; Sunami, E.; Watanabe, T.. "Passage of a sigmoid colon cast in a patient with ischemic colitis.". Int Surg 99 (5): 500-5. doi:10.9738/INTSURG-D-14-00066.1. PMID 25216411.
  2. Erguney, S.; Yavuz, N.; Ersoy, YE.; Teksoz, S.; Selcuk, D.; Ogut, G.; Dogusoy, G.; Alver, O. (Aug 2007). "Passage of "colonic cast" after colorectal surgery: report of four cases and review of the literature.". J Gastrointest Surg 11 (8): 1045-51. doi:10.1007/s11605-007-0194-z. PMID 17564753.
  3. Yoshiji, H.; Nakae, D.; Sugiya, R.; Mizumoto, Y.; Tsutsumi, M.; Hiriguchi, K.; Yokose, Y.; Sakurai, R. et al. (Feb 1994). "Spontaneous passage of a colon cast in the absence of abdominal aneurysm.". J Gastroenterol 29 (1): 80-3. PMID 8199700.
  4. Anaspure, RS; Cheatle, TR (2005). "Spontaneous Passage of a ‘Colon Cast’ Following Aortic Bypass Operation: A Case Report". EJVES Short Reports 9 (5): 96-97. doi:10.1016/j.ejvsextra.2005.02.016.