腹茧症8例诊治分析

The diagnosis and treatment of abdominal cocoon in 8 cases

目的总结腹茧症的临床表现、诊断、治疗及预后。方法回顾性分析2015年1月至2021年12月厦门大学附属中山医院收治的8例腹茧症患者的临床表现、影像学特征、治疗及随访等临床资料。结果本组8例腹茧症患者中1例无腹部症状,7例表现为反复腹痛并伴有完全性肠梗阻或不完全肠梗阻,中位病程时间为6个月(15 d~40年)。6例行腹腔镜腹茧剥离切除+肠粘连松解术,其中1例行腹腔镜手术转开放手术,2例为开腹手术。4例同期行阑尾切除。术后随访3~69个月,有2例并发早期炎症性肠梗阻,1例伤口脂肪液化合并感染,1例术后5个月发生1次肠绞痛,其余患者均恢复良好。结论腹茧症的临床特征不典型,手术是主要的治疗手段,该病的预后总体较好。

Objective To evaluate the diagnosis and treatment of abdominal cocoon.Methods The clinical data of 8 patients with abdominal cocoon in our hospital from Jan 2015 to Dec 2021 were retrospectively reviewed including clinical and imaging manifestations,treatment and follow-up.Results One case was asymptomatic,and the other 7 cases suffered from recurrent abdominal pain with complete or incomplete intestinal obstruction.The median course of disease was 6 months(15 days to 40 years).Six cases underwent laparcoscopic cocoon membrane resection and intestinal adhesion lysis,of which 2 cases underwent laparotomy,one case was converted to open surgery,4 cases underwent concomitant appendectomy.Follow-up ranged from 3 to 69 months,there were 2 cases complicating early inflammatory intestinal obstruction,1 case suffred wound fat liquefaction and infection,1 case with a colic 5 months after operation,and the others were doing well.Conclusions The clinical characteristics of abdominal cocoon disease are not typical.Surgery is the main treatment.The prognosis of the disease is generally fair.