腹茧症的临床特点与诊治经验  

Clinical characteristics and experience for the diagnosis and surgical treatment of abdominal cocoon

作　　者：李斌斌 杨小华[1] 温阳辉 唐祖雄[1] 孙鼎[1] 秦磊[1] 钱海鑫[1] Li Binbin;Yang Xiaohua;Wen Yanghui;Tang Zuxiong;Sun Ding;Qin Lei;Qian Haixin(Department of General Surgery,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院普外科,江苏省215006

出　　处：《中华普通外科杂志》2020年第6期468-470,共3页Chinese Journal of General Surgery

摘　　要：目的探讨腹茧症的临床特点与诊治方法。方法回顾性分析2004年1月至2018年12月间苏州大学附属第一医院收治的28例腹茧症患者的临床资料。结果本组28例腹茧症患者中25例以肠梗阻为首发症状,其中17例为反复发作的慢性肠梗阻,7例伴有腹部包块。25例患者术前影像学检查均发现存在不同程度的肠梗阻。CT或MRI检查显示肠管排列紊乱,聚集成团,管壁增厚,可见包膜。术中见全部或部分小肠被一层灰白色致密坚韧的纤维膜包裹,行包膜切除、肠粘连松解术,必要时可切除部分肠管。6例患者术后出现肠梗阻并发症,均经保守治疗痊愈。结论患者反复出现肠梗阻症状,无其他原因解释,又或合并腹部包块者,应考虑存在腹茧症的可能。术前CT或MRI检查有助于本病的诊断,治疗方式以手术为主。Objective To investigate the clinical characteristics and treatment of the abdominal cocoon.Mehods The clinical data of 28 patients with abdominal cocoon from Jan 2004 to Dec 2018 were analyzed retrospectively.Results Intestinal obstruction was the main clinical manifestations(25 cases),recurrent chronic ileus(17 cases)and abdominal mass(7 cases).Preoperative imaging examination showed varying degrees of intestinal obstruction.CT or MRI scan displayed that small intestinal loops were disorganized,clustered and encased in a thickened capsule.All the cases underwent operations,showing that small bowel were encapsulated in a dense gray-white fibrous membrane.Adhesiolysis and fibrous membrane excision were done with segmental enterectomy when it was necessary.Early postoperative intestinal obstruction occured in 6 cases,all were cured by conservative treatment.Conclusions The combination of clinical symptoms and CT or MRI may facilitate in preoperative diagnosis.Abdominal cocoon is putative diagnosis when recurrent intestinal obstruction with abdominal mass.Surgery is the therapy of choice.

关 键 词：腹茧症 肠梗阻 外科手术 

分 类 号：R656[医药卫生—外科学]