Cağlar Mete, Cetinkaya Nilüfer, Ozgü Emre, Güngör Tayfun
Department of Obstetrics and Gynecology, Düzce University Faculty of Medicine, Düzce, Turkey.
Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
J Turk Ger Gynecol Assoc. 2014 Aug 8;15(3):201-3. doi: 10.5152/jtgga.2014.37268. eCollection 2014.
Sclerosing encapsulating peritonitis, also known as 'Cocoon Syndrome', is a rare cause of bowel obstruction. The condition might be congenital or acquired and has non-specific symptomatology. Abdominal pain occurs due to the limitation of intestinal motility or segment obstruction by a thick homogenous fibrotic mantle covering the intra-peritoneal organs. Altered peritoneal fluid dynamics result in persistent ascites. Leading pathogenic theories are not well defined, but genetic factors, retrograde trans-tubal flow of causative agents, peritoneal infections, medications and peritoneal invasive procedures are all thought to play a role. There are no specific diagnostic criteria and exact diagnosis is only confirmed during surgery when the investing thick fibrous folds covering the bowel loops are visualised. We present here a case that had been suspected to have an ovarian malignancy due to a huge abdominal heterogeneous mass and ascites on preoperative diagnostic workup, but had a final diagnosis of abdominal Cocoon Syndrome made during surgery.
硬化性包裹性腹膜炎，又称“茧状综合征”，是肠梗阻的一种罕见病因。该病可能是先天性的或后天获得性的，症状不具有特异性。由于覆盖腹腔内器官的厚厚的均匀纤维化包膜限制了肠道蠕动或造成节段性梗阻，从而引起腹痛。腹膜液动力学改变导致持续性腹水。主要的致病理论尚未明确，但遗传因素、病原体的逆行经输卵管流动、腹膜感染、药物和腹膜侵入性操作都被认为起了作用。目前尚无特异性诊断标准，只有在手术中看到覆盖肠袢的增厚纤维皱襞时才能确诊。我们在此介绍一例患者，术前诊断检查发现巨大腹部不均匀肿块和腹水，怀疑患有卵巢恶性肿瘤，但手术中最终诊断为腹部茧状综合征。
