Abdominal cocoon syndrome: A rare cause of acute abdomen syndrome
Yıl: 2019 Cilt: 25 Sayı: 6 Sayfa Aralığı: 575 - 579 Metin Dili: İngilizce DOI: 10.14744/tjtes.2019.48380 İndeks Tarihi: 16-06-2020
Abdominal cocoon syndrome: A rare cause of acute abdomen syndrome
Öz: BACKGROUND: A rare cause of acute abdomen or intestinal obstruction, the abdominal cocoon syndrome is also described in theliterature as sclerosing peritonitis or sclerosing encapsulating peritonitis. Abdominal cocoon is characterized by the total or partialwrapping of the abdominal organs by a fibrous membrane. Although it is usually observed in young women, the etiology is unknown.The diagnosis is usually made during laparotomy. In this case series, we aimed to present seven patients diagnosed with abdominalcocoon syndrome during operation.METHODS: The records of patients who underwent laparotomy for abdominal pain and/or intestinal obstruction in our hospitaland diagnosed as abdominal cocoon during operation between January 2012 and November 2018 were retrospectively reviewed. Thedemographic characteristics of the patients, etiologic factors, surgical procedures, operative findings and follow-up of the patientswere recorded.RESULTS: Four out of seven patients who were operated for abdominal cocoon were male and 3 of them were female. The medianage of patients was 61 (57–63) years in male and 39.6 (28–49) years in female. Six of the patients were operated in emergency conditions with the diagnosis of an acute abdomen or ileus. One of the patients was operated with the diagnosis of an intra-abdominalmass in elective conditions. In five out of seven patients, all of the small intestines were wrapped with a fibrous collagen capsule, whiletwo of the patient intestines were partially wrapped with a fibrous collagen capsule. Four of the patients had no underlying disease,while one of the patients had Familial Mediterranean Fever (FMF), one had Endometriosis and one had beta-blocker medication. Onepatient who had small bowel necrosis and septic peritonitis were observed during the operation and died post operative 6th days. Postoperative complications were not observed in the follow-up of other patients and reoperation was not required due to recurrence.CONCLUSION: Abdominal cocoon is a condition that is usually diagnosed during operation in patients that were operated for reasons, such as the acute abdomen or intestinal obstruction. When the diagnose delayed, death can be seen due to small bowel necrosisand septic complications. High clinical suspicion and radiological imaging are important in the preoperative diagnosis. Treatment isrequired adhesiolysis and excision of the fibrous membranes.
Anahtar Kelime: Abdominal koza sendromu: Akut karın sendromunun nadir bir nedeni
Öz: AMAÇ: Literatürde nadir görülen bir akut karın veya bağırsak tıkanıklığı nedeni, abdominal koza sendromu sklerozan peritonit veya sklerozan enkapsüle peritonit olarak tanımlanmaktadır. Abdominal koza, karın organlarının lifli bir zar ile tamamen veya kısmen sarılması ile karakterizedir. Genellikle genç kadınlarda görülmesine rağmen etiyoloji bilinmemektedir. Tanı genellikle laparotomi sırasında yapılır. Bu yazıda, operasyon sırasında abdominal koza tanısı almış yedi hasta sunuldu. GEREÇ VE YÖNTEM: Hastanemiz genel cerrahi kliniğinde Ocak 2012 ile Kasım 2018 tarihleri arasında karın ağrısı ve/veya bağırsak tıkanıklığı nedeniyle laparotomi yapılan ve ameliyat sırasında abdominal koza tanısı alan hastaların kayıtları geriye dönük olarak incelendi. Hastaların demografik özellikleri, altta yatan etiyolojik faktörler, cerrahi işlemler, bulguları ve takipleri kaydedildi. BULGULAR: Abdominal koza nedeniyle ameliyat edilen 7 hastadan dördü erkek, 3’ü kadındı. Ortanca yaş erkeklerde 61 (57-63), kadınlarda 39.6 (28-49) idi. Akut karın veya ileus tanısı ile altı hasta acil durumlarda ameliyat edildi. Elektif koşullarda karın içi kitle tanısı alan bir hasta ameliyat edildi. Yedi hastadan beşinde, ince bağırsakların tamamı bir fibrokollajen kapsül ile kaplıyken, 2 hastada bağırsaklar kısmen fibrokollajen kapsül ile kısmen sarıldı. Hastaların dördünde altta yatan hastalık yoktu, bir tanesinde Ailesel Akdeniz Ateşi (AAA), birinde endometriozis, birisinde betabloker kullanımı vardı. Ameliyat sırasında ince bağırsak nekrozu ve septik peritonit saptanan hasta 6 gün sonra kaybedildi. Diğer hastaların takibinde komplikasyon görülmedi ve hiçbir hasta nüks nedeniyle tekrar ameliyat edilmedi. TARTIŞMA: Abdominal koza, akut karın veya bağırsak tıkanması gibi nedenlerle ameliyat edilen hastalarda genellikle ameliyat sırasında teşhis edilen bir durumdur. Geç tanı konulan olgularda ince bağırsak nekrozu ve septik komplikasyonlar nedeniyle ölüm görülebilir. Preoperatif tanıda yüksek klinik şüphe ve radyolojik görüntüleme önemlidir. Tedavi, fibrokollajen membranın eksizyonu ve adezyolizisdir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | Colak S, BEKTAŞ H (2019). Abdominal cocoon syndrome: A rare cause of acute abdomen syndrome. , 575 - 579. 10.14744/tjtes.2019.48380 |
| Chicago | Colak Sukru,BEKTAŞ Hasan Abdominal cocoon syndrome: A rare cause of acute abdomen syndrome. (2019): 575 - 579. 10.14744/tjtes.2019.48380 |
| MLA | Colak Sukru,BEKTAŞ Hasan Abdominal cocoon syndrome: A rare cause of acute abdomen syndrome. , 2019, ss.575 - 579. 10.14744/tjtes.2019.48380 |
| AMA | Colak S,BEKTAŞ H Abdominal cocoon syndrome: A rare cause of acute abdomen syndrome. . 2019; 575 - 579. 10.14744/tjtes.2019.48380 |
| Vancouver | Colak S,BEKTAŞ H Abdominal cocoon syndrome: A rare cause of acute abdomen syndrome. . 2019; 575 - 579. 10.14744/tjtes.2019.48380 |
| IEEE | Colak S,BEKTAŞ H "Abdominal cocoon syndrome: A rare cause of acute abdomen syndrome." , ss.575 - 579, 2019. 10.14744/tjtes.2019.48380 |
| ISNAD | Colak, Sukru - BEKTAŞ, Hasan. "Abdominal cocoon syndrome: A rare cause of acute abdomen syndrome". (2019), 575-579. https://doi.org/10.14744/tjtes.2019.48380 |
| APA | Colak S, BEKTAŞ H (2019). Abdominal cocoon syndrome: A rare cause of acute abdomen syndrome. Ulusal Travma ve Acil Cerrahi Dergisi, 25(6), 575 - 579. 10.14744/tjtes.2019.48380 |
| Chicago | Colak Sukru,BEKTAŞ Hasan Abdominal cocoon syndrome: A rare cause of acute abdomen syndrome. Ulusal Travma ve Acil Cerrahi Dergisi 25, no.6 (2019): 575 - 579. 10.14744/tjtes.2019.48380 |
| MLA | Colak Sukru,BEKTAŞ Hasan Abdominal cocoon syndrome: A rare cause of acute abdomen syndrome. Ulusal Travma ve Acil Cerrahi Dergisi, vol.25, no.6, 2019, ss.575 - 579. 10.14744/tjtes.2019.48380 |
| AMA | Colak S,BEKTAŞ H Abdominal cocoon syndrome: A rare cause of acute abdomen syndrome. Ulusal Travma ve Acil Cerrahi Dergisi. 2019; 25(6): 575 - 579. 10.14744/tjtes.2019.48380 |
| Vancouver | Colak S,BEKTAŞ H Abdominal cocoon syndrome: A rare cause of acute abdomen syndrome. Ulusal Travma ve Acil Cerrahi Dergisi. 2019; 25(6): 575 - 579. 10.14744/tjtes.2019.48380 |
| IEEE | Colak S,BEKTAŞ H "Abdominal cocoon syndrome: A rare cause of acute abdomen syndrome." Ulusal Travma ve Acil Cerrahi Dergisi, 25, ss.575 - 579, 2019. 10.14744/tjtes.2019.48380 |
| ISNAD | Colak, Sukru - BEKTAŞ, Hasan. "Abdominal cocoon syndrome: A rare cause of acute abdomen syndrome". Ulusal Travma ve Acil Cerrahi Dergisi 25/6 (2019), 575-579. https://doi.org/10.14744/tjtes.2019.48380 |
