Diagnosis and surgical management of abdominal cocoon: results from 12 cases.
This study was designed to describe the characteristics, diagnostic and therapeutic methods of abdominal cocoon. Twelve patients with abdominal cocoon were surgically treated. The clinical findings from these patients were analyzed. All patients presented with acute complete intestinal obstruction, and 10 had a previous history of abdominal mass. In nine patients, the whole or part of the small intestines were covered by an ash gray, dense and tough fibrous membrane. The capsule was surgically excised, and the adhesion was released. Partial resection of the small intestines was performed. In the other three patients, the small intestines were only partially covered by a membrane, and there was an extensive adhesion of intestinal tract, forming a large mass which could not be relieved by surgical lysis. Intestinal tube was put in, and fistulation procedures were performed. All patients recovered fully after the surgery.


CONCLUSIONS
There are four types of surgical findings in abdominal cocoon. The most common type is that the small intestines are fully covered by a thick white membrane, causing intestinal obstruction. Surgical excision of the membrane and the release of adhesion is the treatment of choice.
Liu
Hai-yan
HY
Department of Emergency Medicine, the First Affiliated Hospital of Zhengzhou University 450052, People's Republic of China.
Wang
Yong-sheng
YS
Yang
Wan-guang
WG
Yin
Sheng-lu
SL
Pei
Hui
H
Sun
Tong-wen
TW
Wang
Lexin
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007415:Intestinal Obstruction / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000267:Tissue Adhesions / Q000473:pathology; D055815:Young Adult