腹茧症11例诊治分析

Analysis of diagnosis and treatment for 11 cases of abdominal cocoon

目的探讨腹茧症临床特点、诊断和治疗的方法。方法对2000-08～2010-11住院治疗的11例腹茧症患者的临床资料进行回顾性分析。结果其中,10例表现为急、慢性肠梗阻,6例腹部触诊时可及无痛性质软包块。4例来院前曾在外院接受过剖腹手术1～2次,包括肠粘连松解、包膜部分切除术等。另外1例为结肠癌合并腹茧症。11例均经手术证实为腹茧症,行包膜切除、肠粘连松解术。术后全部治愈出院,随访9例无复发,2例复发肠梗阻,经非手术治疗缓解。结论腹茧症临床表现不典型,诊断困难,误诊率高,确诊需剖腹探查。纤维包膜切除术和肠粘连松解术是治疗腹茧症的有效方法。

Objective To investigate the clinical characteristics and the methods of diagnosis and treatment for abdominal cocoon.Methods The clinical data of 11 patients with abdominal cocoon had been treated from August 2000 to November 2010 were analyzed retrospective1y.Results Among 11 cases 10 presented with acute or chronic intestinal obstruction;A nontender soft abdominal mass was detected by palpation in 6 cases;4 cases had been performed laparotomy in other hospital before admitted author＇s hospital;another cases had colon cancer combined with abdominal cocoon.The diagnosis of abdominal cocoon was confirmed during laparotomy,consequently membran-ectomy and enterolysis was performed in all the patients;9 patients recovered without recurrence within follow-up duration.Ileus reoccurred and was cured through conservative therapy in 2 patients.Conclusion Atypical clinical symptoms of abdominal cocoon make the diagnosis difficult and the final diagnosis could require laparotomy and pathological examination.Membranectomy and enterolysis are of effective procedures in the treatment of this disease.