Defecation of a “colon cast” as a rare presentation of acute graft-versus-host disease

We report a case of a 23-year-old male who had undergone allogeneic HSCT and presented with bloody diarrhea on the 90th day post-HSCT. On the fourth day of admission, the patient passed per rectum a 27-cm long pinkish colored fleshy material recognized as a“colon cast”. Sigmoidoscopy showed a congested and erythematous rectum with the remaining portion of the“colon cast” attached to the proximal part of the sigmoid colon. A biopsy from the rectal wall was suggestive of grade IV GVHD. The patient was treated with methylprednisolone, cyclosporin and mycophenolate mofetil, with a partial response (diarrhea and abdominal pain improved), but then he developed multiple other medical complications and died after 3 months.
Source: Annals of Saudi Medicine - Category: General Medicine Tags: ISSUE 3 Source Type: research