■腹茧综合征(ACS),作为机械性肠梗阻的罕见原因,可分为原发性/特发性vs.次要类型。原发性ACS通常无症状,仅在剖腹探查术中诊断。手术的主要治疗方法可能具有挑战性。由于肠壁和腹膜紧密粘附,肠穿孔可能发生在粘连松解术期间。因此,有一个有经验的外科医生来进行手术是很重要的。
■作者介绍了一个50岁男性的主要ACS病例。患者入院时表现出难以忍受的上腹痛。计算机断层扫描(CT)扫描显示严重的肠梗阻。需要剖腹探查术,导致ACS的诊断,排除次要因素后被认为是特发性的。成功地进行了粘连分解。注意,在手术期间测量的整个肠仅为2.1m。无术后并发症。患者顺利康复。
■原发性ACS的病因未知。发病率相对较低,男女之间被认为是平等的。作为肠梗阻的罕见原因,应加强对诊断的怀疑。包括粘连松解术和肠切除术的手术仍然是主要的治疗方法。如果粘连溶解失败,肠切除将是不可避免的。将测试外科医生的知识和经验。
■应进一步探讨原发性ACS的病因。肠梗阻的鉴别诊断应涵盖ACS,以便外科医生在手术前做好准备。
UNASSIGNED: Abdominal cocoon syndrome (ACS), as a rare cause of mechanical intestinal obstruction, can be divided into primary/
idiopathic vs. secondary type. The primary ACS is often asymptomatic and only diagnosed in exploratory laparotomy. The major treatment of surgery can be challenging. Since the gut wall and peritoneum are densely adhered, gut perforation might occur during adhesiolysis. Thus, it is important to have an experienced surgeon to perform the surgery.
UNASSIGNED: The authors present a primary ACS
case of a 50-year-old man. The patient demonstrated an unbearable upper abdominal pain upon admission. A computed tomography (CT) scan showed a severe bowel obstruction. An exploratory laparotomy was indicated, leading to the diagnosis of ACS, which was considered
idiopathic after ruling out secondary factors. An adhesiolysis was performed successfully. Note that the entire intestine measured was only 2.1 m during the surgery. There was no post-surgical complication. The patient was recovered uneventfully.
UNASSIGNED: The aetiology of primary ACS is unknown. The incidence is comparatively low and considered equal between men and women. As a rare cause of gut obstruction, the suspicion of the diagnosis should be strengthened. Surgery including adhesiolysis and bowel resection remains the major treatment. If adhesiolysis fails, bowel resection will be inevitable. The knowledge and experience of surgeon will be tested.
UNASSIGNED: The aetiology of primary ACS should be further explored. And the differential diagnosis of bowel obstruction should cover ACS in order for the surgeon to be prepared before surgery.