腹茧症的影像及临床诊断

Clinical and imaging diagnosis of abdominal cocoon

目的 提高对腹茧症的认识及影像学诊断能力。方法 分析经手术病理证实的 9 例腹茧症患者的临床及影像诊断资料。结果 临床表现为腹痛9例,腹胀5例,腹部包块 4 例,7 例术前均未明确诊断,分别误诊为卵巢肿瘤蒂扭转 2例,急性弥漫性腹膜炎1例,慢性阑尾炎1例,急慢性肠梗阻3例。2例CT检查诊断为腹茧症。术中发现大网膜短缩4例,缺如5例,全部或部分小肠被一层灰白色致密坚韧的纤维膜包裹。胃肠造影典型表现为小肠聚集成团,呈菜花状或M形排列,且长时间形态不变;典型CT表现为新月形或半圆形低密度(纤维包膜)。均行手术治疗。术后病理确诊为腹茧症。结论 该病临床表现无特异性,术前诊断困难,影像学检查对该病有一定诊断价值,最后确诊需手术及病理。

Objective To study the imaging diagnosis of abdominal cocoon. Methods Nine cases of abdominal cocoon were analyzed. Results Nice cases of confirmed abdominal cocoon with the clinic symptom of abdomenache, 4 cases of abdominal masses, 7 cases were dismissed except 2 cases were diagnosed by CT before surgery. The typical feature of gastrointestinal contrast examination was aggregation of small intestine, like cauliflower or character 'M', being stable for a long time. The typical feature of CT was a crescent or semicircle area with slightly low density (fibroid membrane). The operation demonstrated that the whole or part of the intestine were surrounded by a strong grey fibrofilm. Conclusion No special symptoms is regarded as of abdominal cocoon. Correct imaging diagnosis is difficult prior to operation.Imaging examination is helpful with abdominal cocoon.