- 期刊
Intestinal Obstruction Caused by Abdominal Cocoon in Intestinal Malrotation: Report of a Case
腹繭合併腸道轉位異常所造成之腸道阻塞：病例報告
摘要
腹繭是原因不明且非常罕見的疾病，患者通常是居住在熱帶或亞熱帶的青少年女性。術前診斷不易，而病患通常以腸阻塞的症狀表現。我們報告的病例是位46歲男性，除了有典型的腸阻塞症狀，如腹痛與嘔吐之外，同時合併先天性之腸道扭轉失常。術中發現上腹腔內有一個20×30公分之囊狀腫瘤，透明、纖維性包膜緊緊包裹著小腸腸圈。整段小腸都位於右腹腔，大腸則位於左腹腔。包膜輕易分開後，小腸腸圈立刻順利脫困。病患術後無併發症產生，恢復狀況良好，16天後出院，目前過著正常生活。此病例報告的目的是在面臨腸阻塞病患時提高醫師的警覺性：腹繭的發生，連中年男性也不能排除。
關鍵字
無資料並列摘要
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.
延伸閱讀
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