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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/OL]. 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/OL]. 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
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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.
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