腹茧症8例临床诊治体会

Clinical diagnosis and treatment for 8 cases of abdominal cocoon

目的探讨腹茧症的诊治方法。方法回顾性分析8例腹茧症病例的临床资料。8例均经手术确诊，术中发现腹腔内广泛灰白色纤维膜如“蚕茧状”包裹全部小肠（5例）或部分小肠（3例）。行纤维膜切除及肠粘连松解术，其中部分肠切除吻合术2例，小肠减压术1例。结果8例患者均治愈，病理检查提示纤维组织增生，呈非特异性炎症改变。随访4个月至3年，全部患者均未再出现肠梗阻症状。结论腹茧症的临床表现缺乏特异性，术前诊断困难，影像学检查能为诊断提供一些线索。肠粘连松解术是治疗本病的有效方法。

Objective To explore the methods of diagnosis and treatment of abdominal cocoon. Methods The clinical data of 8 patients with abdominal cocoon were analyzed retrospectively. All the cases were confirmed by operations, which showed that all （5 cases） or part （3 cases） of the small bowel was encapsulated in a dense white - gray membrane like cocoon. All had performed capsulectomy and enterolysis, besides, 2 cases performed partial intestinal resection and intestinal anastomosis, and 1 case performed decompression of intestine. Results All patients were cured. The pathological diagnosis was fibroplasia, presenting changes of non - specificity inflammation. All the cases had not expressed the symptoms of intestinal obstruction in the following 4 months to 3 years. Conclusions The clinical features of abdominal cocoon are lacking of the specificity, and preoperative diagnosis of abdominal cocoon is difficult. Imageology examinations can offer some clues for diagnosis. Enterolysis is an effective method in treating abdominal cocoon.