Hu Qiang, Shi Jianfeng, Sun Yuanshui
Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China.
Front Surg. 2021 Oct 15;8:747151. doi: 10.3389/fsurg.2021.747151. eCollection 2021.
Abdominal cocoon is a very rare abdominal disease. Abdominal cocoon mainly leads to intestinal obstruction, and abdominal cocoon with gastrointestinal perforation is rare. We report a 63-year-old man who was admitted to our hospital with "persistent lower abdominal pain for one day". Abdominal CT examination revealed a small amount of free gas in the abdominal cavity, ascites, and gastrointestinal perforation. An emergency operation was performed. During the operation, the end of the right lower abdominal ileum was found to be conglutinated and twisted into a mass, a local intestinal dilatation, and obstruction, local intestinal wall was black and gangrene, and fecal effusion flowed out. The adhesions were carefully separated, and the necrotic small intestine was removed. The operation process went smoothly, and the patient recovered well after the operation. The cases of intestinal perforation caused by the abdominal cocoon are very rare. In clinical work, when we encounter patients with gastrointestinal perforation, we need to carefully ask the history. When the patients had no digestive system diseases in the past, we need to consider the possibility of the abdominal cocoon with perforation.
腹茧症是一种非常罕见的腹部疾病。腹茧症主要导致肠梗阻，而合并胃肠道穿孔的腹茧症则较为罕见。我们报告一例63岁男性患者，因“持续性下腹痛1天”入院。腹部CT检查显示腹腔内有少量游离气体、腹水及胃肠道穿孔。遂行急诊手术。术中发现右下腹部回肠末端粘连并扭曲成一团，局部肠管扩张、梗阻，局部肠壁呈黑色、坏死，有粪性渗出物流出。小心分离粘连，切除坏死小肠。手术过程顺利，患者术后恢复良好。腹茧症导致肠穿孔的病例非常罕见。在临床工作中，遇到胃肠道穿孔患者时，我们需要仔细询问病史。当患者既往无消化系统疾病时，我们需要考虑腹茧症合并穿孔的可能性。
