Computed Tomographic Findings of an Abdominal Cocoon with Intestinal Obstruction: A Case Report

腹部腸繭合併腸阻塞之電腦斷層發現：病例報告

李覃(Tain Lee) ； 李明德(Ming-Der Lee) ； 許明賢(Ming-Hsiean Hsu) ； 李順安(Shun-An Lee) ； 馬里克(Usman Malik)

《中華放射線醫學雜誌》 35卷1期 (2010/03) Pp. 61-65

摘要

腹部腸繭又稱為硬化包覆型腹膜炎，它是造成腸阻塞罕見的原因，其特徵是某段腸道被緻密纖維化包膜所覆蓋形成類似“繭”之病灶。我們提出一位57歲婦女之病例主要臨床表現是多日來嚴重腹痛及噁心，腹部X光攝影中發現右下腹部有一腫塊陰影合併腸阻塞徵象，後續之腹部電腦斷層檢查影像中可見在右下腹一團迴腸被一薄膜包住，形成類似囊狀或繭狀物，同時合併近端腸阻塞，手術中發現這腸繭位置在距迴音瓣近端30公分處，經由此發現我們強調此典型電腦斷層徵象應為診斷腹部腸繭之依據。

並列摘要

Abdominal cocoon also referred to as sclerosing encapsulating peritonitis, is a relatively rare cause of intestinal obstruction in which variable lengths of bowel is encased in a dense fibrotic membrane with the appearance of a cocoon. We present a case of a 57-year-old woman with severe abdominal pain and nausea. X-ray of abdomen showed a mass-like shadow over right lower quadrant of abdomen with partial intestinal obstruction. Abdominal computed tomogram imaging revealed a conglomerate of several ileal loops surrounded by a thin membrane in right lower abdomen, forming a sac-like structure or a cocoon and associated with proximal intestinal dilatation. Upon surgery, an abdominal cocoon over the terminal ileum, 30 cm proximal to ileo-cecal valve. We would like to emphasize that the typical findings of Computed tomogram (CT) were of significant help in the diagnosis of abdominal cocoon.