Diagnosis and treatment of abdominal cocoon: Clinical analysis of nine cases with a literature review
Objective:To analyze clinical characteristics, diagnosis, and treatment of nine abdominal cocoon patients and to perform a review of the revelant literature to improve surgeons' diagnostic level and understanding of this disease.Methods:Clinical data and surgical results of nine patients with abdominal cocoon diagnosed and treated at Beijing Shijingshan Hospital from 2008 to 2021 were retrospectively analyzed. A literature review was also performed on the diagnosis and treatment of abdominal cocoon patients.Results:This study included a total of 979 patients with abdominal cocoon, of whom 857 (87.5%) had symptoms of intestinal obstruction, and 261 (26.7%) had an abdominal mass. Among the nine cases of abdominal cocoon admitted to our hospital, three (33.3%) showed mesenteric aggregation and traction, and abnormal course of mesenteric blood vessels. Of all the 979 patients included, 721 (73.6%) underwent fibrous capsule excision and intestinal adhesion release, and 246 (25.1%) underwent appendectomy. Postoperative ileus recurred in 134 (23.1%) cases.Conclusion:Patients with abdominal cocoon without symptoms or mild symptoms should be treated conservatively, while patients with abdominal cocoon with acute intestinal obstruction should be treated actively by surgery. Strengthening comprehensive treatment in the perioperative period is helpful to reduce the occurrence of complications.
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