What is the primary treatment for cast syndrome?

Cast syndrome, also known as abdominal compartment syndrome, occurs when a cast, particularly a high thigh or body cast, exerts excessive pressure on the abdomen, leading to a compromised blood supply and function of the intestines. The symptoms can include abdominal pain, nausea, vomiting, and distension, resulting from the entrapment of bowel in the constricted space.

The primary treatment for cast syndrome is the removal of the cast, which alleviates the pressure on the abdomen. In many cases, the placement of a nasogastric (NG) tube may also be indicated to decompress the stomach and intestines. This approach directly addresses the root cause of the syndrome by relieving pressure and allowing for gastrointestinal function to return to normal.

Increasing fluid intake and monitoring vital signs may be supportive measures, but they do not address the underlying issue of the cast causing the syndrome. Similarly, pain relief medications can help manage discomfort but do not resolve the pressure from the cast itself. Physical therapy, while beneficial for improving mobility, does not address the immediate complications caused by cast syndrome that stem from the constricting effect of the cast. Hence, the removal of the cast and use of an NG tube is the definitive action needed to treat this condition effectively.