The cast syndrome--vascular obstruction of the duodenum

Vascular obstruction of the duodenum has been reported as a consequence of the application of a cast or the correction of a spinal curvature following severe burn or combat injuries and complicating treatment of a fractured femur with balanced traction. This syndrome rarly develops more than a week after the application of a cast. An unusual case is reported in which the onset was delayed, but progressed rapidly to a fatal outcome. The pathogenesis, clinical features and treatment of this condition are reviewed. A high index of suspicion in patients at risk is essential as early diagnosis and prompt treatment are imperative.