Recently, the Department of General Surgery admitted a strange patient, Grandma Liu, who has had recurrent abdominal pain for more than 50 years and has not solved the root cause of the disease.
70-year-old Grandma Liu, a native of Youxian County, Zhuzhou, always feels radiant, with sharp legs and feet, and looks several years younger than her actual age. She has two sons and daughters, all of whom are now married, and their children and grandchildren are close to their knees. Grandma Liu has nothing to do at home to raise flowers, occasionally dances square dances, and lives a very comfortable life. When it comes to dissatisfaction with life, she said that the only thing she has is the recurrent abdominal pain that has plagued her for more than 50 years.
When I was about 10 years old, I often had stomach pain, and at that time, my family's financial conditions were limited, so when I was in pain, I rubbed my stomach and took some painkillers. I have several seizures every year, and every time I have an attack, I feel a burst of stomach pain, often I can't get rid of "stool" without farting for several days, and I have nausea and vomiting, and my appetite has become very poor. The doctor said that there was a bit of "intestinal obstruction", which could be relieved by fasting, anti-infection, stomach protection, antispasmodic and pain-relieving treatment. After a long time, I "groped" a set of my own solutions: try to eat only seven or eight minutes full, do not eat particularly greasy and indigestible food, and every time I have abdominal pain, I take a good rest, drink some porridge or be hungry for a few meals, and if I can't stand it, I go to the hospital to prescribe some medicine, and it will be decades like this. Grandma Liu said.
Abdominal pain again**.
In November 2023, Grandma Liu had abdominal pain again, this time it was more painful than before, and rubbing her stomach, injections and medicine did not relieve it. Grandma Liu's son was anxious and hurriedly took her to the emergency department of Changsha Jingkai Hospital for treatment. CT results of abdomen: left middle and upper abdomen small bowel effusion dilation, and inflammatory edema of the intestinal wall, consider inflammatory bowel disease, Crohn's disease? Other? Local intestinal ischemia and necrosis need to be drained, and further clinical examination is required. In order to solve the problem once and for all, the outpatient doctor recommends hospitalization**. Professor Hu Guohuang, vice president and director of the Department of General Surgery of Changsha Jingkai Hospital, recommended surgical exploration based on Grandma Liu's examination report and medical history and symptoms.
Intraoperative findings are huge"Silkworm cocoons"
After careful preoperative preparation, Professor Hu Guohuang and Deputy Chief Physician Mo You arranged surgical exploration for Grandma Liu. After opening the abdominal cavity, everyone was surprised to find that the small intestine had been completely wrapped in a thin layer of gray-white fiber film, like a huge "silkworm cocoon" (known as abdominal cocoon), and the adhesion between the intestines was serious, like wet dough.
Draw "silk" and peel off "cocoon" to keep healthy.
In the face of Grandma Liu's thorny problem, the separation of the small intestine may cause intestinal mucosal rupture and bleeding if you are not careful, the team of Professor Hu Guohuang of Changsha Jingkai Hospital with rich experience and excellent technology, peeled off the "cocoon", carefully and cautiously carried out a difficult and complex intestinal adhesion release and small intestine alignment surgery for Grandma Liu, they overcame various difficulties, after about 5 hours of surgery, the whole process of bleeding was less than 20ml, and the operation was completed perfectly and smoothly. On the 3rd day after surgery, Grandma Liu** vented on her own, and there were no symptoms such as nausea and vomiting after eating, and on the 5th day after surgery, Grandma Liu defecated on her own, recovered well, and was successfully discharged from the hospital.
What is cocoonism.
Abdominal cocoon (AC), also known as congenital small bowel confinement, encapsulated peritonitis, small intestinal cocoon encapsulation, etc., is a clinically rare abdominal disease characterized by the small intestine being cocoon-like wrapped in an abnormal dense, gray-white, tough, hard and thick fibrous membrane. The disease** is not well understood, but it is thought to be related to congenital malformations, external foreign body irritation, viral infection, retrograde infection of the female genital tract, and hematogenous subclinical peritonitis (primary peritonitis). The disease is more common in adolescent women, mostly occurs in tropical and ** regions, mainly manifested as abdominal mass, abdominal pain, bloating, nausea, vomiting and ** decreased or even stopped bowel movement and other intestinal obstructive symptoms, the condition is easy to recur and the course of the disease is different, preoperative diagnosis is difficult, surgery and histopathological examination can be confirmed, and the prognosis is better.
Although abdominal cocoon syndrome is not fatal, it is like putting a "tight spell" on the small intestine, which will further aggravate the peristalsis disorder of the small intestine, impaired digestion and absorption function, and patients will continue to experience abdominal pain, bloating, vomiting and constipation, which will seriously affect the quality of life.
Hunan Medical Chat Special Author: Changsha Jingkai Hospital Li Linfei Follow @Hunan Medical Chat to get more health science information!
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