Jian-fen Yang1, Ning Li, Jie-shou Li. 1. Research Institute of General Surgery, Nanjing General Hospital, Nanjing Command of People's Libration Army, Nanjing 210002, China. jianfenyang@hotmail.com
Abstract
OBJECTIVE: To study the clinical characteristics and the methods of diagnosis and treatment for abdominal cocoon. METHODS: The clinical data of 9 patients with abdominal cocoon treated from July 2000 to February 2004 were analyzed. RESULTS: The clinical manifestations included abdominal pain, abdominal distention, nausea, vomiting, partial or complete intestinal obstruction in 4 cases among 9 cases, abdominal mass in 5 cases. Abdominal plain X-ray and computed tomography suggested partial intestinal obstruction in 8 cases. Computed tomography suggested thickening and rigidity in peritoneum and intestinal wall even a part of calcification in 4 cases. The intestinal loops seemed to be encapsulated in a thickened capsule. Contrast study was negative in 1 case, partial intestinal obstruction in 1 case and intestinal loops fixed at middle abdomen in 1 case among 3 cases. All the cases underwent operations, which showed that part or all the small bowel were encapsulated in a dense white membrane. CONCLUSIONS: Abdominal cocoon is rare. It is more difficult to make right diagnosis preoperatively. A better awareness of this disease and the combination of clinic and radiology may be facilitated in preoperative diagnosis. Abdominal cocoon may be considered when recurrent acute or chronic intestinal obstruction. Surgery was the first choice of therapy.
OBJECTIVE: To study the clinical characteristics and the methods of diagnosis and treatment for abdominal cocoon. METHODS: The clinical data of 9 patients with abdominal cocoon treated from July 2000 to February 2004 were analyzed. RESULTS: The clinical manifestations included abdominal pain, abdominal distention, nausea, vomiting, partial or complete intestinal obstruction in 4 cases among 9 cases, abdominal mass in 5 cases. Abdominal plain X-ray and computed tomography suggested partial intestinal obstruction in 8 cases. Computed tomography suggested thickening and rigidity in peritoneum and intestinal wall even a part of calcification in 4 cases. The intestinal loops seemed to be encapsulated in a thickened capsule. Contrast study was negative in 1 case, partial intestinal obstruction in 1 case and intestinal loops fixed at middle abdomen in 1 case among 3 cases. All the cases underwent operations, which showed that part or all the small bowel were encapsulated in a dense white membrane. CONCLUSIONS:Abdominal cocoon is rare. It is more difficult to make right diagnosis preoperatively. A better awareness of this disease and the combination of clinic and radiology may be facilitated in preoperative diagnosis. Abdominal cocoon may be considered when recurrent acute or chronic intestinal obstruction. Surgery was the first choice of therapy.