Cast syndrome is an uncommon complication in the treatment of orthopaedic conditions. It results from obstruction of third portion of the duodenum by superior mesenteric artery leading to high intestinal obstruction. It should be kept in mind that this obstruction can occur in absence of plaster also because there are many causes to mesentric artery obstruction.

Most cases involve young adults with more than half of these cases have patients with scoliosis or kyphosis or treatment of hip condtions.  It has been seen after casting with body jackets, shoulder spicas, and hip spicas where the common denominator is exten¬sive coverage of the abdomen and chest.

The problem usually is located at the junction of the third and fourth parts of the duodenum, where the duodenum is bound by the ligament of Treitz. The duodenum passes across the anterior aspect of the lumbar spine from right to left at the level of the first and second lumbar vertebrae. Just above this point, the superior mesenteric artery arises from the abdominal aorta and passes downward with its ac¬companying veins in the mesentery. [Read more...]