腹茧症合并术后早期炎性肠梗阻:1例报告并文献复习

Abdominal Cocoon with Early Postoperative Inflammatory Small Bowel Obstruction: One Case Report and Literature Review

目的:探讨腹茧症合并术后早期炎性肠梗阻的诊断与治疗经验。方法:总结1例腹茧症合并术后早期炎性肠梗阻患者的诊治经验并复习文献。结果:本患者为69岁男性,因阵发性腹痛,肛门停止排气、排便,伴呕吐1d入院。急诊行剖腹探查术,术中及术后病理证实为腹茧症,7 d后出现术后早期炎性肠梗阻,经保守治疗痊愈,随访3月正常。结论:腹茧症手术时广泛的粘连分离易导致术后早期炎性肠梗阻,该并发症的治疗应以保守治疗为主;传统的腹茧症手术原则应视情况灵活掌握,不必强求过分的粘连分离,以预防术后早期炎性肠梗阻的发生。

Objective： To investigate diagnosis and treatment of abdominal cocoon with early postoperative inflammatory small bowel obstruction. Methods： The data of one case of abdominal cocoon with early postoperative inflammatory small bowel obstruction was analyzed and related literatures were reviewed. Results. A 69-year old man was admitted to hospital with paroxysmal colicky abdominal pain, constipated, vomit and without flatus for one day. Exploratory laparotomy revealed abdominal cocoon, which was verified by histological examination. Early postoperative inflammatory small bowel obstruction occurred seven days later and treated conservatively. The patient was recovery after three-month＇s follow-up. Conclusion： Extensive adhesion appeared after abdominal cocoon operation could lead to early postoperative inflammatory small bowel obstruction. This complication should be treated conservatively. Surgical principles of abdominal cocoon should be handled differently according to different situations and extensive adhesion should be avoided to prevent early postoperative inflammatory small bowel obstruction.