Peritoneal encapsulation and abdominal cocoon

Abdominal Cocoon in an Aged Man: Report of a Case

“…The clinical symptoms can present as acute bowel obstruction, which necessitates surgical intervention. 1,2,8,9 On the other hand, a congenital cocoon is usually an asymptomatic condition that is found incidentally during unrelated surgery or at autopsy. The main operative fi nding is a thin layer of the peritoneum encapsulating the small bowel, with neither any adhesions nor any evidence of fi brosis on a histopathologic examination.…”

“…1,2 It has been most commonly reported after treatment with a β-adrenergic blocking agent, continuous ambulatory peritoneal dialysis, peritoneo-venous or ventriculo-peritoneal shunting, and it has been mainly observed in young adolescent women, especially those residing in subtropical climates. 1,[3][4][5] We herein describe an aged male patient presenting with an abdominal cocoon without any previous history associated with such a condition.…”

Appearance of “collagen balls” in ascitic fluid cytology with abdominal cocoon (encapsulating peritonitis)

“…Many conditions due to a similar etiological agent occurring in different sets of patients with the different terminology have also been published. [3][4][5][6][7] The etiology of the condition is unknown, but the most common theory is one of membrane formation secondary to peritonitis. 5 However, the association of clinical picture and management of this condition has been the subject of recent reviews, especially for the diagnosis of abdominal cocoon and peritoneal encapsulation.…”

“…5 However, the association of clinical picture and management of this condition has been the subject of recent reviews, especially for the diagnosis of abdominal cocoon and peritoneal encapsulation. 4,5 It is well known that papillary clusters or rosettes of mesothelial cells may be found in the serous effusions and can sometimes be cytologically misdiagnosed as malignant cells. [8][9][10] With Papanicolaou staining, Naylor found 11 that the fragments of collagenous connective tissue covered by mesothelium appear as smoothly contoured, homogenous, pale green bodies covered by a layer of flattened cells.…”

“…Depending on the appearance of the specimen, a variety of terms have been used to describe ball formation: cell balls, 10,12 collagen balls, 13 serosal balls, 1 and collagen stroma. 14 Diagnostic Cytopathology, Vol 16, No 5 ordinary body fluid specimens (i.e., not from ''peritoneal washings'' material) which may be spontaneously exfoliated after injury of serosa and caused by the long-standing condition entitled peritoneal encapsulation. Thus, a distinction should be made between collagen balls, as represented by the present case, and metastatic adenocarcinoma.…”