title: Idiopathic sclerosing encapsulating peritonitis in a young female-diagnosis of abdominal cocoon.
abstract: Abdominal cocoon is a rare cause of relative external small bowel obstruction. It is diagnosed predominantly in female adolescents. Diagnosis is made incidentally at laparotomy. In the past, most patients originated from subtropical regions. We discussed the first patient to be diagnosed as having the said condition in the Netherlands. A preoperative diagnosis would have been facilitated by previous knowledge of the condition. An adopted female adolescent of subtropical origin presented with recurrent failure of intestinal passage at our pediatric surgery ward after referral. Preoperative workup with a contrast-enhanced small bowel passage study showed a gastric and duodenal distension and a cauliflower sign on late passage films. Explorative laparotomy was performed under suspicion of a proximal jejunal obstruction. Findings at laparotomy were characteristic of abdominal cocoon.
authors.affiliation: Department of Surgery, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands. bcL@surgery.azm.nl
authors.forename: Berry
authors.initials: B
authors.lastname: Cleffken
authors.forename: George
authors.initials: G
authors.lastname: Sie
authors.forename: Robbert
authors.initials: R
authors.lastname: Riedl
authors.forename: Erik
authors.initials: E
authors.lastname: Heineman
mesh_terms: D000293:Adolescent; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D007421:Intestine, Small; D007813:Laparotomy / Q000379:methods; D010538:Peritonitis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000473:pathology / Q000628:therapy; D035583:Rare Diseases; D018570:Risk Assessment; D012598:Sclerosis; D012720:Severity of Illness Index; D016896:Treatment Outcome