切换至 "中华医学电子期刊资源库"

中华结直肠疾病电子杂志 ›› 2021, Vol. 10 ›› Issue (04) : 424 -426. doi: 10.3877/cma.j.issn.2095-3224.2021.04.016

所属专题: 经典病例

病例报道

先天性腹茧症伴肠发育不良、大网膜缺如一例报告并文献学习
张童童1, 于溯洋1,(), 周瑾2, 赵士彭1,()   
  1. 1. 050051 石家庄,河北医科大学第三医院胃肠外科
    2. 050051 石家庄,河北医科大学第三医院普通外科
  • 收稿日期:2021-03-25 出版日期:2021-08-30
  • 通信作者: 于溯洋, 赵士彭

A case of abdominal cocoon associated with intestinal dysplasia and great omentum hypoplasia: a case report and literature review

Tongtong Zhang1, Suyang Yu1,(), Jin Zhou2, Shipeng Zhao1,()   

  1. 1. Department of Gastrointestinal Surgery, the Third Hospital Affiliated to Hebei Medical University, Shijiazhuang 050051, China
    2. Department of General Surgery, the Third Hospital Affiliated to Hebei Medical University, Shijiazhuang 050051, China
  • Received:2021-03-25 Published:2021-08-30
  • Corresponding author: Suyang Yu, Shipeng Zhao
引用本文:

张童童, 于溯洋, 周瑾, 赵士彭. 先天性腹茧症伴肠发育不良、大网膜缺如一例报告并文献学习[J]. 中华结直肠疾病电子杂志, 2021, 10(04): 424-426.

Tongtong Zhang, Suyang Yu, Jin Zhou, Shipeng Zhao. A case of abdominal cocoon associated with intestinal dysplasia and great omentum hypoplasia: a case report and literature review[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2021, 10(04): 424-426.

腹茧症是一种非常罕见、病因不明的腹部疾病。全部或部分小肠被一层致密的灰白色或红色的纤维膜所包裹,因此又称为特发性硬化性腹膜炎或硬化性腹膜炎等。1978年由Foo命名为腹茧症。临床医生常常缺乏对本病的认识,诊断比较困难。本例患者以肠梗阻为临床表现就诊,经手术证实为全部小肠及其系膜被纤维膜包裹禁锢,松解纤维膜后发现,全小肠长度仅为1米,考虑为先天性小肠发育不良,该病例非常罕见。

Abdominal cocoon syndrome (ACS), also known as idiopathic sclerosing peritonitis and primary sclerosing peritonitis, is a rare condition, causing small bowel obstruction. It was named by Foo in 1978 as ACS. It is characterized by partial or total encasement of the small intestine in a fibro collagenous cocoon-like sac. Neither the cause nor the pathogenesis has been elucidated fully. Thus, the diagnosis of the disease is difficult since clinicians often lack sufficient understanding of the disease. A patient was received with described symptoms of intestinal obstruction. Surgery shows that the entire small intestine and intestinal mesentery were enveloped in a fibro collagenous sac. The surgically released small intestine was only 1 meter long. Thus it was diagnosed as congenital small intestinal dysplasia, a rare case.

图1 腹部CT。中上腹可见一簇空肠肠袢被膜性结构包绕形成团块,肠系膜上动脉受压向右移位,网膜囊内可见液体影
图2 逐层进腹部,腹膜下即可见淡红色纤维膜包裹全小肠及其系膜,呈囊状,内有黄色液体。囊上界为十二指肠,下界达盲肠水平,左右侧达侧腹壁
图3 纤维膜切开后可见小肠扩张,肠壁水肿增厚。表面有黄色或白色纤维素沉积
图4 完全去除纤维膜后,暴露小肠,测量发现全小肠仅有1米
1
Owtschinnikow PJ. Peritonitis chronica fibrosa incapsulata[J]. Langenbecks Archiv fur Klinische Chirurgie vereinigt mit Deutsche Zeitschrift fur Chirurgie, 1907, 83: 623-634.
2
Foo KT, Ng KC, Rauff A, et al. Unusual small intestinal obstruction in adolescent girls: the abdominal cocoon[J]. Br J Surg, 1978, 65(6): 427-430.
3
杨建芬, 李宁, 黎介寿. 原发性腹茧症的诊断与治疗[J]. 中华外科杂志, 2005, 43(9): 561-563.
4
毛旭南, 徐玉彬, 张培建. 腹茧症病因及诊治的研究进展[J/CD]. 中华普通外科学文献(电子版), 2016, 10(4): 311-314.
5
Tannoury JN, Abboud BN. Idiopathic sclerosing encapsulating peritonitis: abdominal cocoon[J]. Am J Roentgenol, 2004, 183(6): 1658-1660.
6
Sohail MZ, Hasan S, Dala-Ali B, et al. Multiple abdominal cocoons: an unusual presentation of intestinal obstruction and a diagnostic dilemma[J]. Case Rep Surg, 2015, 2015: 282368.
7
Gonnaud L, Alves MM, Cremillieux C, et al. Two new mutations of the CLMP gene identified in a newborn presenting congenital short-bowel syndrome[J]. Clin Res Hepatol Gastroenterol, 2016, 40(6): e65-e67.
8
Werf C, Wabbersen TD, Hsiao N, et al. CLMP Is required for intestinal development, and loss-of-function mutations cause congenital short-bowel syndrome[J]. Gastroenterology, 2012, 142(3): 453-462.e3.
9
Xia J, Xie W, Chen L, et al. Abdominal cocoon with early postoperative small bowel obstruction: A case report and review of literature in China[J]. Medicine (Baltimore), 2018, 97(25): e11102.
10
Al-Azzawi M, Al-Alawi R. Idiopathic abdominal cocoon: a rare presentation of small bowel obstruction in a virgin abdomen. How much do we know?[J]. BMJ Case Rep, 2017, 2017. pii: bcr-2017-219918.
11
Singh H, Irrinki S, Yadav TD, et al. Surgical outcomes in patients with abdominal cocoon: series of 15 patients[J]. World J surg, 2019, 43(9):2143-2148.
[1] 赵海剑, 赵欣, 陈宁, 王健, 朱伦, 张晓雨, 黎珩. 不同状态小肠水通道蛋白3的表达分析及其临床意义[J]. 中华普通外科学文献(电子版), 2023, 17(05): 342-345.
[2] 牛会忠, 刘锋, 张鹏举, 耿建磊, 任慧. 经鼻留置空肠营养管肠内营养支持对新生儿高位肠梗阻手术治疗效果的影响[J]. 中华普通外科学文献(电子版), 2021, 15(06): 437-441.
[3] 杨佩, 刘鹏, 郝少龙, 刘勇, 韩威. 腹腔镜下急性粪石性小肠梗阻切开取石26例分析[J]. 中华普外科手术学杂志(电子版), 2022, 16(03): 351-354.
[4] 叶晋生, 路夷平, 梁燕凯, 于淼, 冀祯, 贺志坚, 张洪海, 王洁. 腹腔镜下应用生物补片修补直肠术后盆底缺损的疗效[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 688-691.
[5] 胡静, 范敏娟, 迟贯华. 经腹腹膜前疝修补术后腹内疝性肠梗阻的发生情况及其影响因素分析[J]. 中华疝和腹壁外科杂志(电子版), 2022, 16(04): 401-405.
[6] 范小彧, 孙司正, 鄂一民, 喻春钊. 梗阻性左半结肠癌不同手术治疗方案的选择应用[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 500-504.
[7] 白峻阁, 王玲玲, 陈海鹏, 刘正. 腹膜粘连的病因、机制及诊治进展[J]. 中华结直肠疾病电子杂志, 2023, 12(02): 112-116.
[8] 倪乾洋, 邢雨彤, 于溯洋. 复杂性“三通”肠瘘一例报告并文献学习[J]. 中华结直肠疾病电子杂志, 2022, 11(06): 521-524.
[9] 张成仁, 吕耀春, 杜斌斌, 柳利利, 路继永, 王帅, 杨熊飞. 直肠癌前切除术后预置回肠造口与袢式回肠造口的对比研究[J]. 中华结直肠疾病电子杂志, 2022, 11(05): 377-383.
[10] 鲍立, 杜瑞, 张仓源, 龙子阳, 孙标, 王道荣. 腹茧症术后合并韦尼克脑病一例[J]. 中华结直肠疾病电子杂志, 2021, 10(05): 550-552.
[11] 闫顺笠, 孙慧敏, 郑朝旭, 刘正, 陈海鹏, 关旭, 庄孟, 黄海洋, 王锡山, 裴炜. 全腹腔镜右半结肠癌根治术后肠梗阻一例并文献复习[J]. 中华结直肠疾病电子杂志, 2021, 10(04): 427-431.
[12] 李周平, 薛晓艳, 徐庆杰, 杜扬帆. 真性红细胞增多症并肠梗阻、抗磷脂综合征一例[J]. 中华重症医学电子杂志, 2022, 08(02): 180-186.
[13] 李明东, 谢红强, 陶涛, 朱萧. 结直肠癌患者术后肠梗阻发生风险列线图预测模型的构建及评估[J]. 中华消化病与影像杂志(电子版), 2021, 11(04): 158-163.
[14] 程相阵. 腹茧症9例诊治分析并文献复习[J]. 中华临床医师杂志(电子版), 2023, 17(9): 968-971.
[15] 刘洋, 彭焘, 万源, 吴可通, 赖海洋, 李丹, 梁锦汉, 张波. 经鼻肠梗阻导管治疗不可切除结直肠癌腹膜转移所致肠梗阻的疗效及预后分析[J]. 中华介入放射学电子杂志, 2021, 09(04): 388-394.
阅读次数
全文


摘要