[The plaster cast syndrome 2 cases of intestinal gastric emphysema]

Two clinical cases of acute gastric dilatation (Cast syndrome) in wearers of surgical corsets for kyphoscoliosis are described. One patient died in spite of surgical treatment, whereas the other responded favourably to conservative management. Fifty cases from the literature are examined. The seriousness and rapid progression of the syndrome are clear from its persistently high mortality (22%). Treatment was conservative in 70% of cases: antishock therapy, nasogastric aspiration, removal of the cast, while duodenojejunostomy was performed in the other 30%. In the two cases described, the seriousness of gastric distress due to compression of the duodenum by the aorta and mesentery was furthered evident from the observation of interstitial gastric emphysema.