Abdominal cocoon secondary to disseminated tuberculosis

Puppala, Radha; Sripathi, Smiti; Kadavigere, Rajagopal; Koteshwar, Prakashini; Singh, Jyoti

doi:10.1136/bcr-2013-202568

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…Obstruction due to adhesions and strictures is not infrequent 11–14. However, presentation as abdominal cocoon is much less frequent 15 16. Among the risk factors for extrapulmonary TB and peritoneal TB, only female gender was in accordance.…”

Section: Discussionmentioning

confidence: 93%

Abdominal tuberculosis: an old disease surprising young doctors

et al. 2016

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Tuberculosis remains a worldwide public health concern. Atypical extrapulmonary presentations may delay the diagnosis and treatment. We present the case of an adult woman admitted to the emergency department with bowel obstruction. The putative intraoperative diagnostic hypothesis was ovarian cancer with peritoneal dissemination. Histopathological analysis showed a chronic granulomatous inflammatory disease with acid-fast bacilli. The patient was started on an alternative parenteral antituberculosis drug combination until oral feeding was available. Currently, 5 months after surgery, she is asymptomatic. Abdominal tuberculosis is the most frequent extrapulmonary site with a wide range of clinical presentations. Emergency laparotomy may be necessary in patients who present with acute abdomen. Bowel obstruction due to adhesions and strictures is not infrequent. However, tuberculous abdominal cocoon presentation as in our patient is rare. Treatment with parenteral alternative drug regimens for tuberculosis is mandatory until the oral route is available.

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Section: Discussionmentioning

confidence: 93%

Abdominal tuberculosis: an old disease surprising young doctors

et al. 2016

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“…25 On pathologic evaluation, fibroconnective tissue proliferation, inflammatory infiltrates and dilated lymphatics, with no evidence of foreign body granulomas, giant cells or birefringent material on the peritoneal tissue are noted. 14 Membrane shows thickened vascular fibrocollagenous tissue, with or without chronic inflammatory reaction evidenced by lymphocytic and plasma cell infiltrates. In tubercular SEP, caseating epithelioid cell granulomas were seen in the membrane, although acid fast bacilli could not be demonstrated.…”

Section: Discussionmentioning

confidence: 99%

“…The causes of secondary SEP include different types of diseases (peritoneal sarcoidosis, cirrhosis, familial Mediterranean fever, systemic lupus), previous surgery (liver and kidney transplantation, shunt surgery), peritoneal infections (tuberculosis, pelvic inflammatory disease), ambulatory peritoneal dialysis catheter, asbestosis exposure, in-vitro fertilization gastrointestinal malignancies, intraperitoneal chemotherapy and various drugs (Beta blockers -practolol, timolol, propranolol, other drugs -methotrexate ). 1,[8][9][10][11][12][13][14] In this study, we aimed to evaluate the clinical features and the treatment options of patients who were diagnosed with primary (ACS) or secondary sclerosing encapsulation syndrome, in differentiation from other causes of ileus and acute abdomen.…”

Section: Introductionmentioning

confidence: 99%

A Diagnostic Dilemma for Acute Abdomen: Sclerosing Encapsulating Peritonitis (Abdominal Cocoon Syndrome); A Retrospective Cohort Study

et al. 2021

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Background: Sclerosing encapsulating peritonitis (SEP) is a rare cause of acute abdomen and can be easily misdiagnosed. Preoperative diagnosis of the SEP can be performed with preoperative imaging studies. We aimed to evaluate the clinical features of ileus cases who were diagnosed with primary or secondary SEP in the last five years. Methods: This retrospective cohort study evaluated the patients who were admitted with ileus or acute abdomen symptoms to the Emergency Department of Elazığ Training and Research Hospital and underwent surgery by the same surgical team of General Surgery Department between January 2014 and January 2019. Patients who were diagnosed with primary or secondary SEP were included. The demographic data, clinical presentation, whether the disease was primary or secondary, the treatment options performed and mortality rates were evaluated. Results: SEP was observed in 11 of the patients. Ten patients underwent surgery (90.9%), and one patient (9.1%) was treated conservatively. Of the patients, six had secondary SEP (54.5%) and five had primary SEP (45.5%). In total, five patients were female (45.5%) and six were male (54.5%). The median age of the patients was 35 years (24-69). The median age of the patients with primary disease was 48 (29-69) years, while the median age of patients with secondary disease was 34.5 (24-64) years. One patient expired in the postoperative 8th hour. Conclusion: SEP should be considered in the case of recurrent abdominal pain attacks, especially in patients undergoing peritoneal dialysis, and it should be known that the mortality rate is high when misdiagnosed.

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