腹茧症的影像及临床诊断

目的提高对腹茧症的认识及影像学诊断能力.方法分析经手术病理证实的9例腹茧症患者的临床及影像诊断资料.结果临床表现为腹痛9例,腹胀5例,腹部包块4例,7例术前均未明确诊断,分别误诊为卵巢肿瘤蒂扭转2例,急性弥漫性腹膜炎1例,慢性阑尾炎1例,急慢性肠梗阻3例.2例CT检查诊断为腹茧症.术中发现大网膜短缩4例,缺如5例,全部或部分小肠被一层灰白色致密坚韧的纤维膜包裹.胃肠造影典型表现为小肠聚集成团,呈菜花状或M形排列,且长时间形态不变;典型CT表现为新月形或半圆形低密度(纤维包膜).均行手术治疗.术后病理确诊为腹茧症.结论该病临床表现无特异性,术前诊断困难,影像学检查对该病有一定诊断价值,最后确诊需手术及病理.

Clinical and imaging diagnosis of abdominal cocoon

Objective To study the imaging diagnosis of abdominal cocoon. Methods Nine cases of abdominal cocoon were analyzed. Results Nice cases of confirmed abdominal cocoon with the clinic symptom of abdomenache, 4 cases of abdominal masses, 7 cases were dismissed except 2 cases were diagnosed by CT before surgery. The typical feature of gastrointestinal contrast examination was aggregation of small intestine, like cauliflower or character "M", being stable for a long time. The typical feature of CT was a crescent or semicircle area with slightly low density (fibroid membrane). The operation demonstrated that the whole or part of the intestine were surrounded by a strong grey fibrofilm. Conclusion No special symptoms is regarded as of abdominal cocoon. Correct imaging diagnosis is difficult prior to operation.Imaging examination is helpful with abdominal cocoon.