Idiopathic abdominal cocoon syndrome with unilateral abdominal cryptorchidism and greater omentum hypoplasia in a young case of small bowel obstruction

Xiang, Fei; Yang, Hai-Rui; Yu, Pengfei; Huang, Sheng; Gu, Guo-Li

doi:10.3748/wjg.v22.i20.4958

Cited by 17 publications

(18 citation statements)

References 11 publications

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“…The net result is fibroblast proliferation, peritoneal fibrosis, and intestinal adhesions eventually leading to capsule or cocoon formation ( Figure 1). 7,8 A variety of causes have been attributed to the etiology. The commonest are peritoneal dialysis related, abdominal tuberculosis, post renal transplantation, use of povidone iodine, long term use of beta blockers and malignancies such as GIST or neuroendocrine tumors.…”

Section: Introductionmentioning

confidence: 99%

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Abdominal cocoon: a surgical challenge

Vagholkar¹,

Doctor-Ganju²

2018

Int Surg J

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Encapsulating peritoneal sclerosis (EPS) or sclerosing peritonitis best described as abdominal cocoon is a complex syndrome characterized by formation of a thick fibrocollagenous membrane that totally encloses the small intestinal loops. The etiology is varied and multifactorial. This complex disease is usually associated with continuous peritoneal dialysis (PD), tuberculosis, post renal transplant, or with long term use of beta blockers. A few cases may even be idiopathic in origin. The pathogenesis is attributed to conversion of epithelial cells from the peritoneal lining to mesenchymal cells leading to a formation of a thick membrane. The clinical features range from abdominal pain due to altered gut motility to frank features suggestive of intestinal obstruction. Making a pre-operative diagnosis is the biggest challenge in abdominal cocoon. However computerized tomography provides enough information to arrive at a diagnosis. Surgical intervention continues to remain the final option in an unremitting intestinal obstruction despite the role of conservative therapy using drugs proposed for treatment. The focus of management is early diagnosis and treatment in order to halt the progression to a frank cocoon. The paper reviews the etiopathogenesis and management of this intricate condition.

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Section: Introductionmentioning

confidence: 99%

“…Surprising associations of abdominal cocoon are cryptorchidism, omental hypoplasias, malrotation of the gut and Treitz's hernia have also been described. 7,8…”

Section: Introductionmentioning

confidence: 99%

Abdominal cocoon: a surgical challenge

Vagholkar¹,

Doctor-Ganju²

2018

Int Surg J

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“…However, few reports have reported the correlation between cryptorchidism and an ileus or small bowel obstruction in children. 7,8 To the best of our knowledge this is the first rare case report of small bowel perforation caused by bilateral cryptorchidism in an adult.…”

Section: Discussionmentioning

confidence: 85%

A Rare Case Report of Small Bowel Perforation Associated with Cryptorchidism in an Adult

Singhal¹,

Jain²,

Shah³

et al. 2019

IJCMSR

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Small bowel obstruction is common complication after abdominal surgery, and can occur due to many reasons. Although obstruction leading to perforation of small bowel is less likely but can occur in some circumstances in which treatment was not taken or misdiagnosed. Case report: We report here 25 year old male with small bowel obstruction caused by adhesions between right side undescended testis and terminal ileum leading to perforation of small bowel proximal to obstruction. Conclusion: Cryptorchidism can cause Small bowel obstruction and perforation in patients with no history of abdominal surgery.

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“…8 Besides these there have been reports of various rare and uncommon etiologies for cocoon summarized in Table 1. [9][10][11][12][13][14][15][16][17][18] A close differential for EPS is peritoneal encapsulation. It's a congenital abnormality where in the small bowel is enclosed in a sac of accessory peritoneum derived from yolk sac due to abnormal return of the physiological umbilical hernia in the abdominal cavity during the twelfth week of gestation.…”

Section: Etiologymentioning

confidence: 99%

Abdominal cocoon: An enigmatic entity

Mandavdhare¹

2016

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Abdominal cocoon, variously described as encapsulating peritoneal sclerosis (EPS) or sclerosing encapsulating peritonitis or peritonitis chronica fibrosa incapsulata, represents a syndrome of clinical symptoms related to formation of a fibro-collagenous peritoneal membrane that involves the small intestinal loops. It is the outcome of several different etiologic processes. The major factors associated with development of an abdominal cocoon include continuous ambulatory peritoneal dialysis, tuberculosis, post-renal or liver transplant, use of beta-blockers although a proportion are of idiopathic origin. It is believed that the pathogenesis is driven by epithelial-to-mesenchymal transition of the mesothelial cells. The clinical presentation is related to development of altered gut motility resulting in abdominal pain and features of intestinal obstruction. Surgery is usually required in cases of unremitting intestinal obstruction. Although computed tomography may provide a pre-operative diagnosis, many cases are diagnosed at the time of surgery. Role of conservative therapy using drugs like steroids, tamoxifen, and mechanistic target of rapamycin (mTOR) inhibitors, or antitubercular therapy (in patients with tuberculosis) is uncertain. Early management aimed at the underlying etiological factor may ameliorate the symptoms and halt progression to formation of frank cocoon. Occasionally, conditions like peritoneal carcinomatosis or peritoneal encapsulation may mimic EPS.

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Idiopathic abdominal cocoon syndrome with unilateral abdominal cryptorchidism and greater omentum hypoplasia in a young case of small bowel obstruction

Cited by 17 publications

References 11 publications

Abdominal cocoon: a surgical challenge

Abdominal cocoon: a surgical challenge

A Rare Case Report of Small Bowel Perforation Associated with Cryptorchidism in an Adult

Abdominal cocoon: An enigmatic entity

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