[Diagnosis and surgical treatment of abdominal cocoon: a report of 16 cases].
OBJECTIVE
To explore the diagnosis and surgical treatment of abdominal cocoon.


METHODS
The clinical data of 16 patients with abdominal cocoon admitted to our hospital between Jun. 1993 and Oct. 2006 were analyzed retrospectively.


RESULTS
Preoperatively, Barium meal X-rays revealed coils of intestine in 8 cases, incomplete intestinal obstruction in 6 cases, and prolonged intestinal transit time in 2 cases. CT scan showed dilated intestine and intestinal loops seemed to be encapsulated in a thickened capsule. After opening the peritoneum, entire or partial intestine encapsulated in thickened membrane encasing were found, including partial intestine encapsulated in 1 cases(Type I), entire intestine encapsulated in 2 cases (Type II), and entire intestine and other organs encapsulated in 12 cases(Type III). All the cases underwent adhesiolysis. Intestinal splint was done in 2 patients, gastrostomy in one patient with chronic pyloric obstruction, radical resection of rectal cancer in one patients and ileocolic resection in one patients with Crohn's disease. All patients were healed by surgical operation and confirmed the diagnosis histopathologically.


CONCLUSIONS
Abdominal cocoon is rare. It is difficult to make a right diagnosis preoperatively. Barium meal X-rays and CT scan are useful methods for its diagnosis. For the treatment, attention should be paid on complete resection of fibrous membrane, adhesiolysis and prevent intestinal obstruction.
Hu
Wei-ming
WM
Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Han
Fang-hai
FH
Zhang
Zhao-da
ZD
Zhou
Xiang
X
Jia
Wei
W
Lu
Hui-min
HM
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005767:Gastrointestinal Diseases; D006801:Humans; D007415:Intestinal Obstruction / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010532:Peritoneal Diseases / Q000175:diagnosis* / Q000601:surgery*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014965:X-Rays; D055815:Young Adult