Surgical Outcomes in Patients with Abdominal Cocoon: Series of 15 Patients.
World J Surg
; 43(9): 2143-2148, 2019 09.
Article
en En
| MEDLINE
| ID: mdl-31011822
ABSTRACT
BACKGROUND:
Abdominal cocoon (AC) or sclerosing encapsulating peritonitis is an uncommon cause of intestinal obstruction. Surgical intervention is warranted in patients with persistent pain or intestinal obstruction.METHODOLOGY:
A retrospective analysis of patients operated for AC was performed. Clinical presentation, radiological data, postoperative outcomes (Ryles tube (RT) removal, duration of hospital stay, enterocutaneous fistula, requirement for re-exploration and mortality) were retrieved and analyzed.RESULTS:
Fifteen patients of abdominal cocoon required surgical intervention for various indications. The mean age was 34.46 years (13-60), and 11 (73.3%) were males. Intermittent abdominal pain was present in 14 (93.3%) followed by recurrent subacute intestinal obstruction (SAIO) in 11 (73.3%). Three patients presented with intestinal perforation. Of the 14 patients with preoperative computed tomography, radiological diagnosis was possible in five patients. The mean duration for surgery was 159 min (60-360 min). Membrane encasement was complete in 9/15 and partial in 6/15 patients. Adhesiolysis was done in all patients (complete-10/15 and partial-5/15). Mean duration for RT removal and hospital stay was 4.3 and 12.3 days, respectively. Recurrence of SAIO was observed in three patients, and one patient needed re-exploration for the same. One patient developed postoperative enterocutaneous fistula requiring surgical intervention. Overall mortality in the study was 13.3% (2/15). Four patients had underlying tuberculosis, and the rest were idiopathic.CONCLUSION:
Etiology of AC is not known in majority of patients. Persistent pain and recurrent SAIO are the most common indications for surgery. This morbidity associated with surgery can be reduced by meticulous dissection techniques and appropriate peri-operative care.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Peritonitis
/
Fibrosis Peritoneal
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Obstrucción Intestinal
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Adolescent
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Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
World J Surg
Año:
2019
Tipo del documento:
Article
País de afiliación:
India