Managing abdominal cocoon syndrome complicated by intestinal necrosis and unexpected amelioration of depression after surgery: a case report.

Autor: Zhang J; Department of General Surgery, Tianjin Union Medical Center, The Affiliated Hospital of Nankai University, Tianjin, 300121, China.; Tianjin Key Laboratory of General Surgery in Construction, Tianjin Union Medical Center, Tianjin, 300121, China., Hsieh Y; Department of General Surgery, Tianjin Union Medical Center, The Affiliated Hospital of Nankai University, Tianjin, 300121, China.; School of Medicine, Nankai University, Tianjin, 300071, China., Zheng K; Department of General Surgery, Tianjin Union Medical Center, The Affiliated Hospital of Nankai University, Tianjin, 300121, China.; Tianjin Key Laboratory of General Surgery in Construction, Tianjin Union Medical Center, Tianjin, 300121, China., Xu J; Department of General Surgery, Tianjin Union Medical Center, The Affiliated Hospital of Nankai University, Tianjin, 300121, China. xujingdoc@126.com.; Tianjin Key Laboratory of General Surgery in Construction, Tianjin Union Medical Center, Tianjin, 300121, China. xujingdoc@126.com.
Jazyk: angličtina
Zdroj: Journal of medical case reports [J Med Case Rep] 2024 Jul 06; Vol. 18 (1), pp. 322. Date of Electronic Publication: 2024 Jul 06.
DOI: 10.1186/s13256-024-04650-9
Abstrakt: Background: Abdominal cocoon is a very uncommon yet dangerous cause of intestinal obstruction.
Case Presentation: We present a case of a 62-year-old Asian male patient with a history of depression who exhibited an idiopathic abdominal cocoon complicated by necrosis. Upon laparotomy investigation, nearly the entire small intestine was enveloped in a thick membrane resembling a cocoon, and it was discovered that he lacked a greater omentum. The patient recovered well and was discharged on an oral diet on the 20th day following surgery. During the 3-month follow-up, the patient was asymptomatic, even gaining 10 kg in weight, and noted that his depression had improved.
Conclusions: Small bowel obstruction presents with nonspecific symptoms, posing challenges in differential diagnosis. Contrast-enhanced computed tomography is recommended since it facilitates precise preoperative assessment, optimizing surgical planning and reducing postoperative complications. Remarkably, cessation of antidepressant medication post-surgery hints at a potential correlation between omental deficit, gut microbiota alterations, and depressive symptoms.
(© 2024. The Author(s).)
Databáze: MEDLINE
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