Abdominal cocoon syndrome: Rare cause of intestinal obstruction—Case report and systematic review of literature

Abstract

Background: Abdominal cocoon or sclerosing encapsulating peritonitis is an uncommon condition in which the small bowel is completely or partially encased by a thick fibrotic membrane. Our study presents a case of sclerosing encapsulating peritonitis and conducts a literature review.Methods: A bibliographic research was conducted. Our research comprised 97 articles. Gender, age, symptoms, diagnostic procedures, and treatment were all included in the database of patient characteristics.Case presentation: A 51-year-old man complaining of a 2-day history of minor diffuse abdominal pain, loss of appetite, and constipation was presented in emergency department. Physical examination was indicative of intestinal obstruction. Laboratory tests were normal. Diffuse intraperitoneal fluid and dilated small intestinal loops were discovered on computed tomography (CT). An exploratory laparotomy was recommended, in which the sac membrane was removed and adhesiolysis was performed. He was discharged on the tenth postoperative day.Results: There were 240 cases of abdominal cocoon syndrome in total. In terms of gender, 151 of 240 (62.9%) were male and 89 of 240 (37%) were female. Ages between 20 and 40 are most affected. Symptoms include abdominal pain and obstruction signs. For the diagnosis of abdominal cocoon syndrome, CT may be the gold standard imaging method. The surgical operation was the treatment of choice in the vast majority of cases (96.7%). Only 69 of 239 patients (28.9%) were detected prior to surgery, and CT was applied in these cases. Conclusion:Abdominal cocoon is a rare condition marked by recurrent episodes of intestinal obstruction. Surgical therapy is the most effective treatment option.

Chronic Encapsulated Sclerosing Peritonitis: A Case Report

“…In our case, the patient presented with intestinal obstruction and acute abdomen in the same way as some previously reported cases [10,11]. The histopathological findings of a thickening of the fibroconnective tissue of the peritoneum, acute and chronic inflammatory infiltrates, lymphatic dilation without evidence of foreign body granulomas, giant cells, or birefringent material give the definitive diagnosis.…”

An Unusual Case of Extranodal Marginal Zone Lymphoma Mimicking Abdominal Cocoon Syndrome in an Adolescent Patient

“…Abdominal cocoon syndrome is rare and characterized by total or partial encapsulation of abdominal organs by dense fibrous adhesions. 13,14 This syndrome most often involves the intestinal tract, presenting with signs and symptoms of obstruction. The etiology is poorly understood, but secondary forms have been described in the setting of intrabdominal inflammation, autoimmune disease, and following abdominal surgery.…”

Primary abdominal cocoon syndrome manifesting with Chilaiditi syndrome and intestinal obstruction: A case report

“…Chorti et al. conducted a systematic review of 240 reported cases of ACS and showed that the most common symptoms include diffuse abdominal pain and bowel obstruction symptomatology 3 . Furthermore, contrast‐enhanced abdominal CT scan was significantly correlated with preoperative diagnosis of ACS which was performed in 43% of patients, and surgical management was the most common treatment for ACS cases.…”

“…This syndrome is more common in tropical and subtropical countries and is predominant in the male population 2 . The clinical manifestations are not specific and preoperative diagnosis is difficult; therefore, nearly 70% of the patients are diagnosed intraoperatively 3 . EPS can be idiopathic or secondary to a wide range of underlying causes.…”