| 摘要 |
The abdominal cocoon is a rare condition of unknown etiology that primarily affects
adolescent girls living in tropical and subtropical regions. It is seldom suspected preoperatively,
and the patients usually present with the typical symptoms and signs of
intestinal obstruction. This paper reports a 46-year-old male who presented with
vomiting and intermittent epigastric pain for several hours. Intestinal obstruction
with echogenic materials in the lumen was found on abdominal sonography, and computed
tomography of the abdomen showed small intestinal obstruction coupled with
suspected colonic malrotation. Exploratory laparotomy showed a huge cystic mass
measuring 20 30 cm, with small intestinal loops encased in a transparent, fibrous
capsule, located in the upper and mid-abdomen. The whole small intestine was
located on the right side, and the large bowel on the left side of the abdominal cavity.
Lysis of adhesions and the cystic wall was easily done, which successfully freed the
entrapped bowel loops. Other than dilatation, the intestinal loops looked grossly
normal, therefore no resections were done. Histology of the specimen from the
capsule and adhesions revealed only fibrosis and congestion. The postoperative
course was smooth and uneventful, and the patient was discharged 16 days after
surgery. Now, at the time of this writing, 15 months after the operation, the patient is
living a normal life. The purpose of this case report is to remind the readers that this
disease can occur even in adult males. |
