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Logo of bmjcrInstructions for authorsCurrent ToCBMJ Case Reports
BMJ Case Rep. 2010; 2010: bcr0420102924.
Published online Jul 26, 2010. doi:  10.1136/bcr.04.2010.2924
PMCID: PMC3027925
Unusual presentation of more common disease/injury
Passage of intestinal (small bowel) cast – an unusual complication of neutropenic sepsis
A Samee,1 R M Kirby,2 and A M Brunt3
1Surgical Directorate, Princess Royal Hospital, Telford, UK
2Department of Surgery, University Hospital of North Staffordshire, Stoke On Trent, UK
3Department of Oncology, University Hospital of North Staffordshire, Stoke On Trent, UK
Correspondence to A Samee, abdussamee2003/at/
A 52-year-old woman was admitted with neutropenic sepsis, 3 days following the final cycle of adjuvant chemotherapy for breast cancer. Her condition deteriorated with progressive abdominal distension, bilious vomiting and diarrhoea. Abdominal examination revealed a mild degree of peritonism. Five days later she passed a small bowel cast per rectum, showing gross fungal contamination on histology. She was managed conservatively with antibiotics and antifungal medications and nutritional support.
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