1 CASE PRESENTATION
Patient: Dong Moumou, gender: male, age: 51 years old, admitted to
hospital for ”intestinal obstruction” due to ”abdominal bloating for
more than 40 years, worsening nausea and vomiting and admitted to
hospital for 20 days”. After repeated treatments in the external
hospital, abdominal pain improved, but repeated attacks. Physical
examination: Vital signs were stable. Normal development, moderate
nutrition, step into the ward, take the lead. Abdominal bulge, abdominal
breathing, no intestinal and peristaltic waves, soft abdomen, no
tenderness in the abdomen, untouched liver, spleen, and kidneys,
Murphy’s sign (-), no percussion in the liver area and both kidney areas
. Mobile dullness (-), bowel sounds 3 times / min, no abdominal murmur.
Auxiliary examination: CT prompts: manifested as small intestine
clustering, dilation of lumen, and fluid accumulation. Cocoon-like,
ring-shaped low-density fiber envelopes can be seen around the lesions.
After enhancement, the envelopes are strengthened. Initial diagnosis:
intestinal obstruction, abdominal cocoon disease is possible. Figure 1.
Enteroscopy tips: narrowing of the small intestine at the end of the
ileum. What was seen during the operation: During the operation, the
omentum was missing. During the operation, the small ileum and sigmoid
colon of the ileum were surrounded by a gray, smooth, tough and thick
fibrous membrane, which looked like a silkworm cocoon. There is also
fibrous membrane adhesion between the intestine and the intestine. The
small intestine could not be separated. The small intestine of the ileum
was resected and intestinal anastomosis was performed. The sigmoid colon
was subjected to fibrous membrane resection and intestinal adhesions
were loosened. Intraoperative as shown in Figure 2. After the operation,
the specimen was broken open and the small intestine enveloped as shown
in Figure 3. Postoperative medical examination supports intraoperative
diagnosis. The patient recovered well and was discharged smoothly.