Hernia de Spiegel: a propósito de un caso / Spiegel Hernia. About a case

Presentamos el caso de una mujer de 86 años con una hernia espigeliana complicada por la oclusión intestinal, cuyo diagnóstico se basó en semiología y tomografía computarizada. En la anamnesis, informó dolor en la fosa ilíaca derecha asociada con los vómitos. El examen físico mostró una masa dura, sensible y móvil ubicada en la fosa ilíaca derecha. La tomografía computarizada abdominal mostró un saco hernial de 13 mm con un cuello en la fosa ilíaca derecha, frente a la aponeurosis del músculo oblicuo externo. Eso contenía grasa y un bucle de intestino delgado. El diagnóstico de hernia espigeliana atascada. La cirugía se realizó con un manejo postoperatorio simple.

We present the case of an 86-year-old woman with a Spigelian hernia complicated by intestinal occlusion, whose diagnosis was based on semiology and computed tomography. In the anamnesis, he reported pain in the right iliac fossa associated with vomiting. Physical examination showed a hard, sensitive, and mobile mass located in the right iliac fossa. abdominal computed tomography showed a 13-mm hernial sac with a neck in the right iliac fossa, in front of the aponeurosis of the external oblique muscle. That contained fat and a loop of small intestine. The diagnosis of stuck Spigelian hernia. The surgery was performed with simple postoperative management

Peutz-Jeghers syndrome: an unusual autopsy finding in pregnancy

Peutz-Jeghers syndrome (PJS) is a rare autosomal dominant polyposis entity that often remains undiagnosed. The major problems associated with PJS are acute complications due to (i) polyp-related intestinal obstruction, (ii) intussusception, and (iii) the risk of cancer in the long-term. We report the case of a 32-year-old female who presented at the emergency room with signs of acute abdomen and died during the clinical workup. She had a one-month history of nausea, vomiting, and diarrhea and was pregnant at about 30 weeks. There was no contributing past history except for undergoing small bowel resection in infancy. The postmortem examination revealed multiple arborizing polyps throughout the gastrointestinal tract, chiefly in the small bowel. Intestinal obstruction was found at the proximal jejunum with necrosis, perforation, and peritonitis. Histologically, the polyps were composed of tree branch-like bundles of smooth muscle covered by normal-appearing glandular epithelium, confirming the diagnosis of hamartomatous polyps. No malignant or premalignant lesions were detected in the gastrointestinal tract or other organs. This case was an opportunity to analyze the natural history and the pathological features of the Peutz-Jeghers syndrome in an adult and to investigate the presence of neoplastic lesions associated with this condition.

Phenotypic changes of interstitial cells of Cajal after intestinal obstruction in rat model

The objective was to study the effect of mechanical intestinal obstruction in rats on the phenotype of interstitial cells of Cajal (ICC). Healthy Wistar rats were randomly divided into sham-operation group (C), one day obstruction group (M1), two days obstruction group (M2), and three days obstruction group (M3), with 10 rats in each group. The expression of SCF mRNA and c-Kit protein in intestinal tissue was investigated by RT-PCR and immunohistochemistry. Compared with the sham-operation group, the relative expression of SCF mRNA and the expression of c-Kit protein in intestinal tissue were significantly decreased in both obstruction groups. Levels decreased gradually with the prolongation of obstruction time, and significantly decreased on the 3rd day after obstruction (P<0.05). Immunohistochemical staining of the small intestine showed that the number of ICC in the sham-operation group was the highest, and they were gradually decreased with the extension of obstruction time in the M1 to M3 groups. There was a significant difference between groups (P<0.05). Intestinal obstruction caused a decrease in the concentrations of SCF mRNA and c-Kit protein in ICC. With the prolongation of intestinal obstruction, the number of ICCs gradually decreased.

Melanoma as a surprising solution to the puzzle of intestinal obstruction

Abstract We present a case of a 71-year-old man with an advanced melanoma of the right colon. The final diagnosis was determined based on histopathological examination of the material collected during urgent laparotomy performed due to ileus. Although we considered the tumor to be a disseminated primary melanoma of the colon, the possibility of unknown primary origin could not be excluded. Palliative chemotherapy and radiotherapy reduced symptoms associated with the disease and prolonged patient's survival.

Mechanisms of growth inhibition of Phytomonas serpens by the alkaloids tomatine and tomatidine

Phytomonas serpens are flagellates in the family Trypanosomatidae that parasitise the tomato plant (Solanum lycopersicum L.), which results in fruits with low commercial value. The tomato glycoalkaloid tomatine and its aglycone tomatidine inhibit the growth of P. serpens in axenic cultures. Tomatine, like many other saponins, induces permeabilisation of the cell membrane and a loss of cell content, including the cytosolic enzyme pyruvate kinase. In contrast, tomatidine does not cause permeabilisation of membranes, but instead provokes morphological changes, including vacuolisation. Phytomonas treated with tomatidine show an increased accumulation of labelled neutral lipids (BODYPY-palmitic), a notable decrease in the amount of C24-alkylated sterols and an increase in zymosterol content. These results are consistent with the inhibition of 24-sterol methyltransferase (SMT), which is an important enzyme that is responsible for the methylation of sterols at the 24 position. We propose that the main target of tomatidine is the sterols biosynthetic pathway, specifically, inhibition of the 24-SMT. Altogether, the results obtained in the present paper suggest a more general effect of alkaloids in trypanosomatids, which opens potential therapeutic possibilities for the treatment of the diseases caused by these pathogens.

Alteraciones del equilibrio ácido-básico en pacientes operados por oclusión intestinal mecánica / Alterations of the acid-base balance in patients surgically treated for mechanical intestinal obstruction

Introducción: las alteraciones del medio interno conducen a una alta morbilidad y mortalidad, en pacientes portadores de oclusión intestinal, consideradas como una complicación grave si no se realiza una adecuada evaluación y corrección de estas. Objetivo: caracterizar el comportamiento de las principales alteraciones del medio interno relacionado con el balance ácido-básico en pacientes operados por oclusión intestinal mecánica. Métodos: se realizó un estudio observacional, descriptivo de serie de casos, de todos los pacientes operados por oclusión intestinal desde el 1ro de enero del año 2009 al 31 de diciembre del año 2012 en el Hospital Saturnino Lora Torres". El universo fue constituido por un total de 257 pacientes. Se seleccionó una muestra de 207. Fue calculada la prueba chi cuadrado de independencia para identificar asociación estadísticamente significativa entre variables seleccionadas. Resultados: existió predominio del sexo masculino así como los mayores de 61 años. Las bridas fueron la causa más frecuente de la oclusión. La etiología tumoral tuvo el resultado más significativo vinculado con la mayoría de las alteraciones del equilibrio ácido básico. El tiempo de evolución de los síntomas fue directamente proporcional a la aparición de los trastornos identificados. La mortalidad de la serie estuvo dominada por pacientes con diagnóstico de oclusión por neoplasia. Se identificó una alta incidencia de alteraciones hemogasométricas en pacientes que fallecieron. Conclusiones: la presencia de alteraciones ácido.básicas entorpece el curso y pronóstico de los pacientes con oclusión intestinal mecánica(AU)

Introduction: alterations of the internal environment leading to high morbidity and mortality in patients who suffer intestinal obstruction are considered serious complication if they are not adequately evaluated and corrected. Objective: to characterize the behavior of the main alterations in the internal environment related to the acid-base balance in patients operated on for intestinal mechanical obstruction. Methods: observational and descriptive case series study in patients operated on for intestinal obstruction from January 1st 2009 to December 31st 2012 in Saturnino Lora Torres hospital. The universe of study was made up of 257 patients, being the final sample 207 individuals. The chi-square statistic tests of independence were calculated to identify statistically significant association among the selected variables. Results: males as well as over 61 years-old patients prevailed. The intestinal adhesions were the most common cause of obstruction. The tumor etiology was the most significant outcome associated with most of the acid-base alterations. The length of progression of symptoms was directly proportional to the occurrence of identified disorders. The mortality of the series mainly occurred in patients with cancer occlusion due to high incidence of hemogasometric alterations present in deceased patients. Conclusions: the presence of acid-base alterations makes the course and prognosis of patients with mechanical intestinal obstruction gloomy(AU)

Intestinal obstruction due to Basidiobolus ranarum: An unusual case.

A case of intestinal obstruction caused by extensive soft tissue fungal infection of the perineum due to Basidiobolus ranarum is presented here. There was excellent response to antifungal treatment. A literature search revealed the case report of intestinal obstruction due to intrinsic mucosal involvement by the fungus, but extensive soft tissue involvement of the perineum resulting in extraneous obstruction to the rectum, has not been reported so far.

Enterocyte ultrastructural alterations following intestinal obstruction in rats / Alterações ultra-estruturais do enterócito após obstrução intestinal em ratos

PURPOSE: To analyze the small intestinal mucosa ultrastructure, and to characterize the enterocyte lesion severity caused by mechanical intestinal obstruction combined or not with an ischemia of the mesenteric marginal vessels arch. METHODS: It was used 47 Wistar rats divided into 4 groups as follows: Group 1- Control rats (C), Group 2- sham rats (S), Group 3- rats submitted to intestinal obstruction excluding marginal vessel (OEV), Group 4- Intestinal obstruction including marginal vessels (OIV). Rats of groups 3 and 4 were allotted into two subgroups for the removal of small intestinal tissue samples, one at the proximal (P), and the other at the distal (D) segments from the obstruction site. Samples of groups 2, 3, 4 were obtained 24, 48, and 72 hours after post operation care. Small intestinal tissue samples of group 1 were excised following laparotomy. Imaging in Light and Transmission Electronic Microscopy were used for morphological and morphometric studies. The results were analyzed by using the ANOVA and Newman-Keuls tests. RESULTS: No irreversible lesion was observed. In the 24 hours microvilli volume of group 3 turned down at the proximal site henceforth enlarging very slowly within the next 72 hours. At the distal site significant microvilli shrinkage was observed up to 48 hours. Then they recovered their volume after 72 hours. In the 24 hours microvilli volume of group 4 grew twice in comparison with the microvilli of group 1 rats but after 72 hours there was drastic volume shrinkage, shape alterations, and severe flatness, especially in the distal segments of the obstruction site. CONCLUSIONS: Terminal ileum mechanical obstruction with mesenteric marginal arch ischemia led to reversible ultrastructural alterations after 72 hours, and the injury is proportional to the persistence of the obstructive process. Furthermore the mesenteric vessels of the marginal arcade play an important role in the maintenance of mucosal integrity, ...

OBJETIVO: Analisar as alterações ultra-estruturais da mucosa do intestino delgado e caracterizar a severidade das lesões causadas por uma obstrução intestinal mecânica, associada ou não a isquemia da arcada marginal mesentérica. MÉTODOS: Foram utilizados 47 ratos, da linhagem Wistar, distribuídos em quatro grupos, da seguinte forma: Grupo 1 - Controle (C), Grupo 2- Simulação (S), Grupo 3- Ratos com obstrução intestinal sem inclusão de vaso marginal (OEV), Grupo 4 - Obstrução intestinal com inclusão de vaso marginal (OIV). Os animais dos grupos 3 e 4 foram redistribuídos em dois subgrupos com coleta de amostras do intestino delgado, à montante (P) e à jusante (D) do ponto de obstrução. Nos grupos 2, 3 e 4, as amostras foram colhidas com 24, 48 e 72 horas de pós-operatório. No grupo 1, este material foi retirado após laparotomia. Realizaram-se estudos morfológicos e morfométricos dos microvilos através das Microscopias Óptica e Eletrônica de Transmissão. Os resultados foram analisados mediante os testes estatísticos de ANOVA e Newman-Keuls. RESULTADOS: Não foram observadas lesões irreversíveis. No grupo 3 com 24 horas, o volume dos microvilos diminuiu, à montante, com discreto aumento em 72 horas. Á jusante, houve redução significante até 48 horas, com recuperação em 72 horas. No grupo 4, o volume dos microvilos quase dobrou em relação ao grupo 1, com 24 horas, mas reduziu-se, drasticamente, em especial à jusante, com 72 h de evolução, apresentando deformidade e achatamento severos, achados estes estatisticamente significantes. CONCLUSÕES: A obstrução intestinal mecânica do íleo terminal, associada ou não a isquemia da arcada mesentérica marginal, causa alterações ultra-estruturais reversíveis dos enterócitos, cuja gravidade é diretamente proporcional à duração do processo mórbido obstrutivo, até 72 horas de evolução. Aduz-se que, os vasos mesentéricos da arcada marginal exercem um papel relevante na preservação da mucosa intestinal, na ...

Oclusión intestinal: nuestra experiencia en el tratamiento quirúrgico / Bowel obstruction: authors' experience with the surgical management

El síndrome de Oclusión Intestinal representa entre un 20 % y 30 % de los cuadros de Abdomen Agudo. El objetivo es relacinar edad, sexo, riesgo ASA, altura de la oclusión, retardo en el tratamiento quirúrgico con mortalidad, complicaciones médicas y quirúrgicas. Se realizú en el Servicio de Guardia Central H:N:C. UNC.. Diseño: estudio prospectivo y protocolizado. Material y métodos: entre enero de 2004 y enero de 2007, se operaron 52 pacientes con un cuadro de oclusión intestinal. Del total 32 de ellos fueron hombres y 20 mujeres; el promedio de edad correspondió a 52,11 años. Riesgo Quirúrgico: el 46,15 % de los pacientes presentó riesgo A.S.A. III, 38,69 % riesgo A.S.A. II, 11,53 % riesgo A.S.A. I y 9,61 % riesgo A.S.A. IV. Los síntomas mós frecuentes fueron dolor abdominal y distensión abdominal y los signos de distensión abdominal y timpanismo abdominal. Resultados: en las Oclusiones altas las Bridas fueron la causa más frecuente y en Oclusiones bajas el Cáncer de sigmoides. La mortalidad global fue de 13,45 %. Respecto de las Complicaciones médicas postquirúrgicas, 14 pacientes en total las presentron, la más frecuente fue la Insuficiencia Renal Aguda con 9 casos. respecto de las complicaciones del acto quirúrgico, 12 pacientes en toal las presentron; las más frecuentes fueron las infecciones de la herida quirúrgica con 7 casos. Conclusiones: el riesgo A.S.A. elevado mostró ser uno de los factores predictivos más importantes respecto del incremento de la mortalidad en cuadros oclusivos de urgencia, junto con la edad y el retraso de la indicación quirúrgica.

Bowel obstruction syndrome represents 20 to 30 % of acute abdominal consult. Objectives: to relate age, gender, ASA risk, large or smal intestinal obstruction, opportunity chirurgic treatment, medical and clinic complications. Establishment: Central Guard Service of N.C.H. of the C.N.U. Design: protocolized and prospective study. Methods and materials: between January 2004 and January 2007 it has been operated 52 patients with acute bowel obstruction, 32 of them were males and 20 females. The middle age eas 52,11 years. Chirurgic risk: 46,15 % had ASA risk III, 38,69 % had ASA risk II, 11,53 % had ASA risk I, and 9,61 % had ASA risk IV. Most common sympotom was abdominal pain and abdominal distension, and the most common signs were distension and tympanic abdominal. Results: the most common cause of small bowel obstruction sigmoid cancer. Global mortality was 13,45 %. Post chirurgic complications: 9 patients had acute renal failure and 7 had wound surgery infection. Conclusions: the most important factors that increase mortality on acute bwel obstructions are elevated risk ASA, age adn retard of surgery treatment.

Bacterial translocation in an experimental intestinal obstruction model: C-reactive protein reliability? / Translocação bacteriana no modelo experimental de obstrução intestinal: A proteína C-reativa é confiável?

BACKGROUND: Bacterial translocation occurs in preseptic conditions such as intestinal obstruction through unclear mechanism. The C-reactive protein is an acute phase reactant and a marker of ischemia. METHODS: 45 albino male rats were divided into 3 groups each 15 rats. GI control, GII simple intestinal-obstruction and GIII strangulated obstruction. Outcome measures were: (1) Bacteriologic count and typing for intestinal contents, intestinal wall, liver, mesenteric lymph nodes and blood (cardiac and portal) (2) Histopathologic: mucosal injury score, inflammatory cell infiltrate in the wall, MLN, liver, (3) Biochemical: serum CRP, IL-10, mucosal stress pattern (glutathione peroxidase-malonyldialdhyde tissue levels). RESULTS: (1) Intestinal obstruction associates with BT precursors (Bact-overgrowth, mucosal-acidosis, immuno-incomptence), (2) Bacterial translocation (frequency and density) was found higher in strangulated I.O, that was mainly enteric (aerobic and anaerobic) and mostly E.coli, (3) The pathogen commonality supports the gut origin hypothesis but the systemic inflammatory response goes with the cytokine generating one. (4) The CRP median values for GI, II, III were 0.5, 6.9, 8.5 mg/L, for BT +ve 8 mg/L and 0.75 mg/L for BT -ve rats. CONCLUSION: Bacterial translocation occurs bi-directional (systemic-portal) in intestinal obstruction and the resultant inflammatory response pathogenesis is mostly 3 hit model. The CRP is a non selective marker of suspected I.O cases. However, it is a reliable marker of BT, BT density and vascular compromise during I.O.

OBJETIVO: Translocação bacteriana ocorre em condições pré-sépticas como na obstrução intestinal por mecanismo não esclarecido. A proteína C-reativa é um marcador de ischemia em fase aguda. A proposição é investigar os possíveis efeitos da obstrução intestinal no equilíbrio ecológico microbiano. MÉTODOS: 45 ratos machos albinos foram distribuídos em três grupos de 15 ratos. GI controle, GII obstrução intestinal simples e GIII obstrução estrangulada. As medidas adotadas foram: (1) Contagem bacteriológica do conteúdo intestinal, parede intestinal, fígado, linfonodos mesentéricos e sangue (coração e portal) (2) Avaliação histopatológica da lesão da mucosa, infiltrado celular inflamatório da parede, linfonodos mesentéricos, fígado, (3) Avaliação bioquímica. RESULTADOS: (1) Obstrução intestinal está associada a precursora translocação bacteriana (crescimento bacteriano, acidose da mucosa, imuno-incompetência), (2) Translocação bacteriana (freqüência e densidade) foi maior na obstrução intestinal estrangulada, principalmente entérica (aeróbios e anaeróbios), sobretudo E.coli, (3) A ocorrência comum é de origem intestinal. CONCLUSÃO: A translocação bacteriana na obstrução intestinal é bi-direcional (sistêmica e portal) A proteina C-reativa não é um marcador seletivo na suspeita de obstrução intestinal. Contudo é marcador confiável da translocação bacteriana, na densidade e comprometimento durante a obstrução intestinal.

Ileo biliar: presentación de un caso y revisión de literatura / Biliary obstruction: presentation of a case and review of literature

Este trabajo presenta un caso de Ileo Biliar en paciente femenino de 75 años, con enfermedad de 4 días de evolución caracterizada por vómitos incontables de aspecto fecaloideo, ausencia de evacuaciones y dolor abdominal tipo cólico. Se llevó a mesa operatoria evidenciando cálculo atascado de 5 cm de longitud por 3 cm de ancho en ileon distal a 25 cm de la válvula ileocecal, con dilatación proximal de asas delgadas. Se realiza extracción del mismo mediante enterotomía y enterorrafía en dos planos. La paciente presenta evolución satisfactoria. El ileo biliar es causa de obstrucción intestinal poco frecuentre, aparece generalmente en mujeres de más de 60 años. El cálculo biliar pasa generalmente a intestino, a través de la fistulización de la pared biliar en duodeno o yeyuno, tras prolongado decúbito, produciendo la neumatización del arbol biliar. Posteriormente el cálculo emigra hasta íleon distal, donde puede quedar detenido y provocar un cuadro de obstrucción de intestino delgado.

Obstrução intestinal e tricobezoar: relato de um caso recidivante / Trichobezoar and intestinal obstruction: report of a recurrent case

Introdução: Tricofagia é o ato de mastigar e engolir cabelos. Tricobezoares são aglomerado de cabelo singeridos, afetando mais comumente o estômago e o duodeno, podendo causar obstruções, perfurações, ulcerações e sangramentos. Relato do Caso: A finalidade do presente trabalho é relatar o caso de uma paciente com história de cirurgia por tricobezoar há 16 anos, apresentando, no momento da admissão, quadro de obstrução intestinal de mesma etiologia, sendo necessário tratamento cirúrgico para retirada de um tricobezoar gástrico e outro intestinal, o qual causava obstrução a dez centímetros da válvula íleo-cecal. Discussão: O presente relato destaca-se pelo fato de que a paciente apresentou recorrência do tricobezoar e pela obstrução intestinal baixa concomitante. Conclusão: A recorrência do tricobezoar é rara, porém deve ser aventada como hipótese diagnóstica em pacientes que já apresentaram tal afecção e procuram atendimento médico com obstrução intestinal.

Trichophagy is the act of chewing and swallowing hair. Trichobezoars are glomerate of ingested hair, more commonly affecting the stomach and duodenum. They cause obstructions, perforations, ulcerations and bleedings. The purpose of this study is to report the case of a female patient with intestinal obstruction caused by trichobezoars, admitted at a school hospital who had already been submitted to a laparotomy 16 years ago for the same reason. The obstruction was resolved by removing the trichobezoar from the stomach and the ileum after gastrotomy and enterotomy. This case can be considered important since it reports the trichobezoar recurrence as well as the presence of intestinal obstruction . Trichobezoar recurrence is rare, however, this hypothesis must be considered in patients with previous history of this affection who looks for medical assistance in the presence of intestinal obstruction.

Endometriosis del íleon como causa de obstrucción intestinal: Report of two cases / Ileal endometriosis as a cause of intestinal obstruction. Report of two cases

Endometriosis is a common, chronic, benign, estrogen dependent gynecological disorder associated to pelvic pain and infertility. Its main characteristic is the presence of endometrial tissue outside the uterus. The prevalence of pelvic endometriosis ranges between 6% and 10% women during their reproductive years. Clinical symptoms of pelvic endometriosis are pelvic pain, dysmenorrhea, dispareunia and infertility. Distal ileum endometriosis is an uncommon cause of intestinal obstruction with a frequency of 7% to 23% of all cases with intestinal involvement. We report two patients, 30 and 34 years old, with terminal ileum endometriosis and intestinal obstruction that required surgery and intestinal resection. Both patients are well one year after the operation.

Distension abdominal y edemas por quiste del cordon espermatico / Abdomina distention and edema due to spermatic cord cyst

La distensión abdominal es un síntoma común, siendo en general la presentación inicial de enfermedadessistémicas o desórdenes gastrointestinales. Otras causas son infrecuentes. Los quistesdel cordón espermático son poco frecuentes, pero aún más su ubicación intraabdominal, su tamaño habitual esinsuficiente para producir distensión. El paciente presentado en este caso es un varón con criptorquidia bilateraladmitido por distensión abdominal, interpretada inicialmente como síndrome ascítico edematoso. La ecografíainterpretó la distensión como ascitis tabicada, y la tomografía computada como debida a un gran quiste. En laexploración quirúrgica se diagnosticó un quiste gigante del cordón espermático de ubicación abdominal.

Abdominal distention is a frequentsymptom, being often the initial presentation of systemic diseases or gastrointestinal disorders. Othercauses are uncommon. Spermatic cord cysts are infrequent, abdominal location is even rarer, and the size ofthe cysts is usually not enough to produce abdominal distention. In our case a man with bilateral cryptorchidismwas admitted with abdominal distention and edema of the lower extremities initially interpreted as asciticedematoussyndrome. Ultrasonography interpreted abdominal distention as septate ascites, computed tomographyas a giant cyst. Exploratory surgery showed a giant spermatic cord cyst in the left spermatic cord.

A Giant Colonic Hamartoma and Multiple Colonic Hamartomatous Polyps in a Middle-Aged Man

Colonic hamartomas are rare polypoid lesions. We report an unusual case of multiple colonic hamartomatous polyps, including a giant hamartoma, unrelated to hereditary or familial polyposis syndromes, in a 48-year-old man. The diameter of the largest polyp was 9.5 cm, and endoscopy revealed that the lesion caused colonic obstruction. The clinical, endoscopic and histological aspects of this case are discussed.

Intestinal neuronal dysplasia type A.

Intestinal neuronal dysplasia is a rare cause of bowel obstruction in neonates and infants, the diagnosis of which poses a formidable challenge to both clinicians and pathologists alike. The importance of this entity lies not only in the fact that it mimics Hirschsprung's disease, but also in that untreated cases, particularly of type A, may prove fatal. The authors describe one such case of intestinal neuronal dysplasia of type A, which was diagnosed at autopsy.

Obstrução intestinal por metástase de carcinoma lobular de mama / Intestinal obstruction due to lobular heart carcinoma metastasis

Comprometimento metastático do trato gastrointestinal secundário ao câncer de mama é raro. Os autores relatam um caso de metástase de carcinoma lobular de mama em jejuno de mulher de 71 anos, causando obstrução intestinal.

Obstruçäo incomum do intestino delgado: abdome de "Cocoon" / Anusual small intestinal obstruction: the abdominal \"Cocoon\"

Descrito primeiro por Foo e colaboradores em 1978, abdome de "Coccon" é um caso raro de obstrução intestinal. Ocorre geralmente em mulheres jovens e é caracterizada por uma membrana fibrosa que envolve a parte distal ou todo o intestino delgado. Invariavelmente apresenta-se como uma obstrução ou semi-obstrução intestinal, com ou sem massa. Ralatamos um caso de abdome de "Cocoon" com a presença de uma massa, numa paciente do sexo feminino, 16 anos, o qual foi diagnosticado intra-operatoriamente. Este é o primeiro caso brasileiro relatado desta condição rara