Cleffken Berry, Sie George, Riedl Robbert, Heineman Erik
Department of Surgery, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
J Pediatr Surg. 2008 Feb;43(2):e27-30. doi: 10.1016/j.jpedsurg.2007.11.012.
Abdominal cocoon is a rare cause of relative external small bowel obstruction. It is diagnosed predominantly in female adolescents. Diagnosis is made incidentally at laparotomy. In the past, most patients originated from subtropical regions. We discussed the first patient to be diagnosed as having the said condition in the Netherlands. A preoperative diagnosis would have been facilitated by previous knowledge of the condition. An adopted female adolescent of subtropical origin presented with recurrent failure of intestinal passage at our pediatric surgery ward after referral. Preoperative workup with a contrast-enhanced small bowel passage study showed a gastric and duodenal distension and a cauliflower sign on late passage films. Explorative laparotomy was performed under suspicion of a proximal jejunal obstruction. Findings at laparotomy were characteristic of abdominal cocoon.
腹茧症是相对少见的引起小肠外梗阻的病因。主要在青春期女性中被诊断出来。多在剖腹手术时偶然发现。过去，大多数患者来自亚热带地区。我们讨论了在荷兰被诊断为此病的首例患者。若此前了解这种疾病，术前诊断会更容易。一名来自亚热带地区的养女青少年在被转诊后，在我们的小儿外科病房反复出现肠道排气排便障碍。术前通过对比增强小肠造影检查发现胃和十二指肠扩张，延迟造影片上有菜花征。因怀疑近端空肠梗阻而进行了剖腹探查术。剖腹手术所见具有腹茧症的特征。
