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October 1963

The Cast Syndrome: A Case Report

Author Affiliations

From the Department of Surgery, Rhode Island Hospital.

Arch Surg. 1963;87(4):662-665. doi:10.1001/archsurg.1963.01310160124024

Profound gastric atony associated with epigastric pain, bloating, intermittent vomiting, and moderate to severe degrees of alkalosis following the application of a body cast is a syndrome that has been reported infrequently in the medical literature. The seriousness of the condition is clearly apparent from a review of the 11 published cases, in four of which the patient died. Dorph's1 case report and review of the literature in 1950 served to establish the term "cast syndrome," and its various features were stressed later that year in an editorial by Leucutia.2 The first case to fulfill the criteria for the cast syndrome as outlined by Dorph was reported by Willett3 in 1878. Single case reports appeared subsequently by Buzzard (1880),4 Kelling (1901),5 and by Conley and Miller ( 1935).6 Four of the five patients died, presumably from the effects of severe metabolic alkalosis. All of the

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