Abdominal Cocoon: An Unusual Presentation of Small Bowel Obstruction

Abstract

Abdominal cocoon is a rare condition. It presents as a thick whitish membrane which covers bowel loops. Because of this presentation, it is also called as sclerosing encapsulating peritonitis. It is usually diagnosed intra operatively. Treatment of this condition involves resection of the membrane and release of adhesions. Pre-operatively, patient is investigated for recurrent episodes of small bowel obstructions. However, preoperative diagnosis does not change the treatment and management. Investigations done preoperatively help in expediting the treatment with planned laparotomy.

Difficult to Diagnose the Cause of Intestinal Obstruction due to Abdominal Cocoon Syndrome

“…Abdominal cocoon syndrome, also known as sclerosing encapsulating peritonitis (SEP), is a condition in which the small intestine is partially or completely encapsulated by a fibrocollagenous membrane. It is difficult to diagnose preoperatively [1] . We present the case of a 46-yearold patient with small bowel obstruction symptoms diagnosed intraoperatively and successfully treated with surgery.…”

Abdominal cocoon: idiopathic sclerosing encapsulating peritonitis

“…The idiopathic form is also known as abdominal cocoon 1. Secondary causes usually occur in patients on peritoneal dialysis 2. The condition is difficult to diagnose preoperatively.…”

Idiopathic cocoon abdomen with congenital colon malrotation: a case report and review of the literature

“…Abdominal CT: the sign on CT is shown as a serpentine configuration of dilated small intestinal loops in a Ushaped cluster. Contrast-enhanced CT is the imaging modality of choice for the diagnosis of an abdominal cocoon [13] and Preoperative Contrast-enhanced CT can diagnose it accurately [14,15]. The main symptom of cocoon abdomen is encapsulated sign.…”