Unusual Cause of Mechanical Ileus: Abdominal Cocoon Syndrome

Ceulemans, Laurens J.; Deferm, Nathalie P.; Deferm, SÃ©bastien; Willaert, Robin A.V.; Deferm, J.T.; Vanhoenacker, Filip

doi:10.5334/jbr-btr.1062

Cited by 4 publications

(3 citation statements)

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“…Peritoneal fibrosis lead to ascites by blocking the lymphatic vessels, which is a nonspecific symptom (21). The most common manifestation of the disease is small bowel obstruction, which is characterized by complete or partial obstruction (16,17,22) and this was observed in approximately two-thirds of the cases in the current study. Signs of bowel function disorder were not only related to the encapsulated intestine but also the damaged vessels, vas lymphatica and nerve plexus of the bowel wall muscular layer.…”

Section: Discussionmentioning

confidence: 53%

Imaging and treatment of idiopathic abdominal cocoon in 9 patients

Rui

Yang

et al. 2019

Exp Ther Med

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The aim of the current study was to investigate the imaging features of abdominal cocoon (AC), the methods of diagnosis and treatment of AC and improve understanding of AC. To do this, the current study retrospectively analyzed the clinical data and imaging findings of nine patients with AC. The clinical manifestations included intestinal obstruction in six out of the nine cases of AC, which included two cases of bowel strangulation and five cases of soft masses in the abdomen. Imaging features of AC included the following: i) Bowel loops were usually present in a fixed cluster; ii) bowel loops were encapsulated partially or totally by a thickening fibrous membrane-like ‘cocoon’; iii) bowel wall thickened in the ‘cocoon’, and the bowel loops and sac adhered; iv) loculated ascites in the ‘cocoon’; v) abnormal clustering of the mesenteric vasculature, hypoplasia of the omentum majus was present or absent; and vi) Ileus occurred in some cases. The features of a plain abdominal X-ray, a gastrointestinal barium meal series and ultrasonography lacked specificity. The results of CT in eight out of nine cases of AC were consistent with the surgical findings. Surgery was the first choice of therapy. All cases were treated surgically, showing that the bowel loops were encapsulated partially or totally by a thickened fibrous membrane. All cases received operations including partial or total excision of the membrane and enterolysis. In conclusion, CT may be highly valuable in the preoperative diagnosis of AC.

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Section: Discussionmentioning

confidence: 53%

Imaging and treatment of idiopathic abdominal cocoon in 9 patients

Rui

Yang

et al. 2019

Exp Ther Med

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“… 9 The most common manifestation of SEP is small intestinal obstruction, which accounts for two thirds of the patients. 10 This disease can be divided into two categories of primary SEP also known as idiopathic sclerosing peritonitis, abdominal cocoon, or abdominal cocoon syndrome, and secondary SEP. The precise definition of primary SEP is that there is no accurate factor to explain this disease.…”

Section: Discussionmentioning

confidence: 99%

Sclerosing encapsulating peritonitis: three case reports and review of the literature

Zhang

2020

J Int Med Res

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Sclerosing encapsulating peritonitis (SEP) is a disease that is rarely encountered clinically. Preoperative diagnosis of SEP can be difficult. However, with imaging technology, such as computed tomography (CT), this condition can be diagnosed without surgery and pathological analysis. SEP is characterized by small intestine being partially or completely encased by a layer of a thick grayish-white fibrocollagenous membrane similar to a cocoon. The most common symptoms of SEP are abdominal pain, nausea, and vomiting. SEP often leads to intestinal obstruction. Our hospital treated three emergency patients who complained of acute or chronic abdominal pain. CT showed “cauliflower sign” in two cases. The three patients were diagnosed with SEP intraoperatively. In a female patient with ascites, the situation was extremely serious, and this condition had not been reported in detail previously. Fortunately, all patients were discharged without complications. We should pay special attention to patients with SEP who have ascites, which indicates a serious situation.

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“…Laparoscopic surgery has also been performed for abdominal cocoon. 11,12 The decision of performing laparoscopy in case of bowel obstruction must be individualized based on the patient's condition and surgeon's expertise. In some patients with active inflammation and severe adhesions in the abdomen, surgery may not be feasible due to the high risk of iatrogenic bowel perforation.…”

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confidence: 99%