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腹茧症合并术后早期小肠梗阻:一例病例报告及中国文献复习

Abdominal cocoon with early postoperative small bowel obstruction: A case report and review of literature in China.

作者信息

Xia Jie, Xie WeiJia, Chen Li, Liu Daren

机构信息

Second Affiliated Hospital of Zhejiang University school of medicine, Hangzhou, China.

出版信息

Medicine (Baltimore). 2018 Jun;97(25):e11102. doi: 10.1097/MD.0000000000011102.

Abstract

RATIONALE

Abdominal cocoon is a condition in which intestinal obstruction results from the encasement of part or whole of the small bowel by a thick fibrous membrane, giving the appearance of a cocoon. The preoperative diagnosis is difficult to be made and the treatment is still controversial.

PATIENT CONCERNS

Here we describe the case of a 62-year-old male presented with a 24-h history of continual colicky abdominal pain, which was accompanied with nausea and vomiting.

DIAGNOSIS

Accurate diagnosis of abdominal cocoon was made intraoperatively.

INTERVENTIONS

Membrane excision and adhesiolysis were performed and the patient experienced early postoperative small bowel obstruction. Nasointestinal obstruction tube was then installed and bowel function was gradually recovered by the 20th postoperative day.

OUTCOMES

The patient recovered well and was discharged from the hospital on the 30th postoperative day LESSONS:: Abdominal cocoon can occur at any age. The possibility of abdominal cocoon should also be considered in infertile patients. Imaging studies may be helpful to make the correct diagnosis, and surgery should be performed for patients with recurrent acute or chronic intestinal obstruction.

摘要

理论依据

腹茧症是一种因部分或全部小肠被一层厚厚的纤维膜包裹而导致肠梗阻的病症,形似茧状。术前诊断困难,治疗仍存在争议。

患者情况

在此我们描述一例62岁男性患者,有持续24小时的阵发性绞痛病史,伴有恶心和呕吐。

诊断

术中准确诊断为腹茧症。

干预措施

进行了膜切除和粘连松解术,患者术后早期出现小肠梗阻。随后置入鼻肠减压管,术后第20天肠道功能逐渐恢复。

结果

患者恢复良好,术后第30天出院。

经验教训

腹茧症可发生于任何年龄。不孕患者也应考虑腹茧症的可能性。影像学检查可能有助于做出正确诊断,对于复发性急性或慢性肠梗阻患者应进行手术治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bbd/6023681/899583f47331/medi-97-e11102-g001.jpg

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