A rare cause of small bowel obstruction: Abdominal cocoon

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• 作者：Abdul-Wahed Meshikhes ; ^{meshikhes@gmail.com} ; Shoukat Bojal
• 关键词：Abdominal cocoon ; Intestinal obstruction ; Surgery ; Adhesionlysis
• 刊名：International Journal of Surgery Case Reports
• 出版年：2012
• 期刊代码：pca193_22102612
• 类别：med
• 出版时间：2012
• 卷：3
• 期：7
• 页码：272-274
• 文件大小：554 K

摘要

INTRODUCTION

The clinical manifestations of abdominal 鈥榗ocoon鈥?are non-specific and hence its diagnosis is rarely made preoperatively and the management is often delayed. Surgery remains the main stay of treatment with satisfactory outcome and comprises excision of the fibrous membrane, meticulous adhesionolysis and release of the entrapped small bowel.

PRESENTATION OF CASE

A 45-year-old male patient presented with 6-month history of progressive subacute small bowel obstruction. After initial radiological investigations, he underwent diagnostic laparoscopy and was misdiagnosed as abdominal tuberculosis. He was started on anti-tuberculous therapy, but exploratory laparotomy was carried out after failure to respond to anti-tuberculous therapy. At laparotomy, the abdominal 鈥榗ocoon鈥?which was encapsulating the entire small bowel was excised, and the adhesions were carefully lysed. The patient remained well and without recurrence at 1-year follow-up.

DISCUSSION

Abdominal 鈥榗ocoon鈥?is a rare cause of subacute, acute and chronic small bowel obstruction. Its diagnosis is rarely made preoperatively.

CONCLUSION

Abdominal 鈥榗ocoon鈥?should be thought of as a rare cause of small bowel obstruction. It may be mistaken with abdominal tuberculosis. Surgery remains the mainstay of curative treatment.