Journal of Surgery Concepts & Practice ›› 2019, Vol. 24 ›› Issue (03): 259-263.doi: 10.16139/j.1007-9610.2019.03.017

• Original article • Previous Articles     Next Articles

Clinical analysis of abdominal cocoon: a report of 9 cases

XIA Yia, TANG Yonghuab, GENG Zhichaoa, ZHAO Xuesongb, HUANG Lianga, MAO Enqianga, CHEN Erzhena, WANG Xiaoyana   

  1. a. Department of Emergency, b. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2018-09-30 Published:2019-06-25

Abstract: Objective To analyze retrospectively the clinical manifestation and radiological findings of abdominal cocoon combined with the diagnosis, treatment and prognosis. Methods The data of 9 patients with abdominal cocoon in our hospital from January 2007 to June 2018 were reviewed including clinical feature and follow-up. Results Four cases were diagnosed as abdominal cocoon by CT examination before operation, and the remaining five cases were diagnosed by laparotomy. One case received non-operative treatment and 8 cases had operation. During the operation, some cases were found part of small intestine to be encapsulated in a cocoon-like membrane, some had all small intestine wrapped and some had part of colon involved. The main operation was to excise cocoon, lysis adhesion and release intestine. One case died due to multiple organ failure and 4 cases had early intestinal obstruction postoperatively. During a follow-up of 8 cases within the period from 6 months to 10 years, 1 case was lost followed up. Chronic abdominal pain was found in 1 case, intestinal obstruction in 2 cases and abdominal distention in 1 case. The other 3 cases recovered well. Conclusions Preoperative diagnosis of abdominal cocoon is difficult for there is no specific clinical manifestations. The characteristic images of abdominal enhanced CT scan with or without two dimensional reformations may be preoperative diagnostic clues. The main treatment of abdominal cocoon is surgery, and the overall prognosis of patients is satisfactory.

Key words: Abdominal cocoon, Abdominal CT, Intestinal obstruction

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