title: Diagnosis and Treatment of 26 Cases of Abdominal Cocoon.
abstract: Abdominal cocoon (AC) is a rare abdominal disease with nonspecific clinical features, and it is difficult to be diagnosed before operation and hard to be treated in clinical practice. The aim of this study is to investigate the diagnosis and treatment of AC.
  
  
  
  The clinical manifestations, findings during surgery, treatments, and follow-up results of 26 cases of AC were retrospectively studied from January 2001 to January 2015.
  
  
  
  All of 26 cases were diagnosed as AC definitely by laparotomy or laparoscopic surgery. Their clinical findings were various, with 7 intestines obstructed with bezoars and 4 intestines perforated by spiny material. Based on the existence of the second enterocoelia, all cases were categorized into 2 types: type I is absent of second enterocoelia (18 cases, 69.23%), while type II shows second enterocoelia (8 cases, 30.77%). Twenty cases (12 were type I and 8 were type II) underwent membrane excision and careful enterodialysis to release the small intestine entirely or partially, while the other 6 cases (all were type I) did not. In addition, all patients were treated with medical treatment and healthy diet and lifestyle. Finally, most of the patients recovered smoothly.
  
  
  
  AC can be categorized into two types; surgery is recommended for type II and part of type I with severe complications, but sometimes conservative therapy might be appropriate for type I. Laparoscopic surgery plays an important role in the diagnosis and treatment of AC. Furthermore, favorite health education, healthy diet and lifestyle are of significance in patients' recovery.
authors.affiliation: Southern Medical University, Guangzhou, China.|Department of Gastrointestinal Surgery, Central Hospital of Shaoyang, Shaoyang, Hunan, China.|Department of General Surgery, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Li
authors.affiliation: Southern Medical University, Guangzhou, China.|Department of General Surgery, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Jun-Jiang
authors.initials: JJ
authors.lastname: Wang
authors.affiliation: Southern Medical University, Guangzhou, China.|Department of General Surgery, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Wei-Xian
authors.initials: WX
authors.lastname: Hu
authors.affiliation: Southern Medical University, Guangzhou, China.|Department of General Surgery, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China.|Department of Gastrointestinal Surgery, First Hospital of Ningbo, Ningbo, Zhejiang, China.
authors.forename: Mou-Cheng
authors.initials: MC
authors.lastname: Zhang
authors.affiliation: Department of Gastrointestinal Surgery, Central Hospital of Shaoyang, Shaoyang, Hunan, China.
authors.forename: Xian-Yan
authors.initials: XY
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of General Surgery, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Guan-Fu
authors.initials: GF
authors.lastname: Cai
authors.affiliation: Department of Gastrointestinal Surgery, Central Hospital of Shaoyang, Shaoyang, Hunan, China.
authors.forename: Sen-Lin
authors.initials: SL
authors.lastname: Liu
authors.affiliation: Southern Medical University, Guangzhou, China. yjb9211@21cn.com.|Department of General Surgery, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China. yjb9211@21cn.com.
authors.forename: Xue-Qing
authors.initials: XQ
authors.lastname: Yao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000072700:Conservative Treatment; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D056627:Peritoneal Fibrosis / Q000145:classification / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult