Abdominal cocoon syndrome as a rare cause of mechanical bowel obstruction: report of two cases

Yenıay, Levent; Karaca, Cezmi; Çalışkan, Cemil; Fırat, Özgür; Ersin, Sinan; Akgün, Erhan

doi:10.5505/tjtes.2011.39018

Cited by 20 publications

(22 citation statements)

References 6 publications

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“…When the etiologic factors and past medical history of patients were evaluated four of patiets had no etiological cause, one patient had medication of betablocker, one patient had endometriosis and one patient had FMF. The median hospitalisation in our study was 9.5 (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) days. The follow-up period of our patients was 35.57 (3-75) months and two patients were hospitalized for follow-up because of subileus attacks, but re-operation was not required.…”

Section: Resultsmentioning

confidence: 70%

“…In the surgery, excision of the fibrous capsule and adhezyolizis are performed. [11] Surgical intervention has many complications, such as iatrogenic bowel injury and recurrent ileus due to adhesions in the early period. In this study, we aimed to investigate the patients who were operated for acute abdomen or ileus between January 2012 and November 2018 and who had ACS detected during exploration.…”

Section: Introductionmentioning

confidence: 99%

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Abdominal Cocoon Syndrome: A rare Cause of Acute Abdomen Syndrome

Çolak¹

2019

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: A rare cause of acute abdomen or intestinal obstruction, the abdominal cocoon syndrome is also described in the literature as sclerosing peritonitis or sclerosing encapsulating peritonitis. Abdominal cocoon is characterized by the total or partial wrapping of the abdominal organs by a fibrous membrane. Although it is usually observed in young women, the etiology is unknown. The diagnosis is usually made during laparotomy. In this case series, we aimed to present seven patients diagnosed with abdominal cocoon syndrome during operation. METHODS: The records of patients who underwent laparotomy for abdominal pain and/or intestinal obstruction in our hospital and diagnosed as abdominal cocoon during operation between January 2012 and November 2018 were retrospectively reviewed. The demographic characteristics of the patients, etiologic factors, surgical procedures, operative findings and follow-up of the patients were recorded. RESULTS: Four out of seven patients who were operated for abdominal cocoon were male and 3 of them were female. The median age of patients was 61 (57-63) years in male and 39.6 (28-49) years in female. Six of the patients were operated in emergency conditions with the diagnosis of an acute abdomen or ileus. One of the patients was operated with the diagnosis of an intra-abdominal mass in elective conditions. In five out of seven patients, all of the small intestines were wrapped with a fibrous collagen capsule, while two of the patient intestines were partially wrapped with a fibrous collagen capsule. Four of the patients had no underlying disease, while one of the patients had Familial Mediterranean Fever (FMF), one had Endometriosis and one had beta-blocker medication. One patient who had small bowel necrosis and septic peritonitis were observed during the operation and died post operative 6 th days. Postoperative complications were not observed in the follow-up of other patients and reoperation was not required due to recurrence. CONCLUSION: Abdominal cocoon is a condition that is usually diagnosed during operation in patients that were operated for reasons, such as the acute abdomen or intestinal obstruction. When the diagnose delayed, death can be seen due to small bowel necrosis and septic complications. High clinical suspicion and radiological imaging are important in the preoperative diagnosis. Treatment is required adhesiolysis and excision of the fibrous membranes.

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Section: Resultsmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Abdominal Cocoon Syndrome: A rare Cause of Acute Abdomen Syndrome

Çolak¹

2019

Ulus Travma Acil Cerrahi Derg

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“…In physical examination of ACS patient, an asymmetric distension which does not move with peristalsis due to fibrous capsule surrounding small bowels is observed in the inspection of abdominal area. Besides in palpation of abdominal wall, enlarged bowel in the proximal of the adhered section is palpated soft while the obstructed zone is palpated as a rigid, flat, and painless area due to fibrous tissue [14,15]. None of our patients had clinical or radiological findings indicative of ACS in preoperative period.…”

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confidence: 84%

Two Different Clinical Approaches with Mortality Assessment of Four Cases: Complete and Incomplete Type of Abdominal Cocoon Syndrome

Akbaş

Hacım

Dagmura

et al. 2020

Case Reports in Surgery

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Abdominal cocoon syndrome (ACS), also called sclerosing encapsulated peritonitis, is a condition characterized by encapsulation of all or some of small bowel loops by a thick fibrous membrane. Etiologic cause is not fully known. It is among the rare causes of intestinal obstruction in adults. Preoperative diagnosis is difficult, and high suspicion is required. Diagnosis is generally made during laparotomy performed due to mechanical obstruction. In treatment of the condition, large scale surgical resections should be avoided. In the present study, we aimed to evaluate all clinical and radiological characteristics and surgical treatment of ACS in light of the literature through four patients operated in our clinic.

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“…The clinical presentation of the abdominal cocoon syndrome mostly occurs as acute abdomen, which, in most cases, requires surgical intervention. Preoperative diagnosis of the syndrome is usually difficult [13]. Various treatment options are adopted, such as subtotal excision of the membrane, enterolysis, small bowel intubation, bowel resection, and exploratory laparotomy with postoperative medical treatment in patients with high perforative risk [14].…”

Section: Discussionmentioning

confidence: 99%

Abdominal Cocoon: A Rare and Difficult Togetherness in Trauma Patient

Oymacı¹

2016

Ann Clin Anal Med

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ÖzetSklerozan enkapsüle peritonit olarak bilinen abdominal koza, ince barsakların fibrokollejenöz bir membran ile tamamen yada kısmen sarıldığı nadir bir mekanik intestinal obstrüksiyon nedenidir. Genç adolesan kadınlarda görülmekte ve olguların büyük bir kısmında etyoloji bilinmemektedir. Cerrahi acil vakalarda bu nadir olgunun akılda tutulması tedavide gecikmeleri önleyebilir ve hasta için gereksiz girişimleri engelleyebilir. Travma nedeni ile opere ettiğimiz ve teşhis ve tedavide zorlanmaya neden olan abdominal koza olgusunu sunuyoruz. Anahtar KelimelerPeritonit; Multipl Travma; Genel Cerrahi Abstract Abdominal cocoon, as known sclerosing encapsulating peritonitis, is a rare condition of mechanical intestinal obstruction due to total or partial encapsulation of the small bowel by a fibrocollagenous membrane. It has been reported mainly in young adolescent women and the majority of the cases are of unknown etiology. Awareness of this rare cause of surgical emergency may prevent delay in treatment and avoid unnecessary procedures for the patient. We are presenting an operated abdominal cocoon case which can be cause difficulty in diagnose and treatment.

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Abdominal cocoon syndrome as a rare cause of mechanical bowel obstruction: report of two cases

Cited by 20 publications

References 6 publications

Abdominal Cocoon Syndrome: A rare Cause of Acute Abdomen Syndrome

Abdominal Cocoon Syndrome: A rare Cause of Acute Abdomen Syndrome

Two Different Clinical Approaches with Mortality Assessment of Four Cases: Complete and Incomplete Type of Abdominal Cocoon Syndrome

Abdominal Cocoon: A Rare and Difficult Togetherness in Trauma Patient

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