Abdominal cocoon-A rare cause of intestinal obstruction.
BACKGROUND
Abdominal cocoon syndrome is characterized by small bowel encapsulation by a fibro-collagenous membrane or "cocoon". It is a rare cause of intestinal obstruction.


METHODS
A 42-year old man presented with sub-acute intestinal obstruction. Intra-operatively, the entire small bowel was found to be encapsulated in a dense fibrous sac. The peritoneal sac was excised, followed by lysis of the inter-loop adhesions. Postoperative recovery was unremarkable.


CONCLUSIONS
Most patients with abdominal cocoon syndrome present with features of recurrent acute or chronic small bowel obstruction secondary to kinking and/or compression of the intestines within the constricting cocoon. An abdominal mass may also be present due to an encapsulated cluster of dilated small bowel loops.


CONCLUSIONS
Abdominal cocoon is a rare condition causing intestinal obstruction and diagnosis requires a high index of suspicion because of the nonspecific clinical picture. CECT of the abdomen is a useful radiological tool to aid in preoperative diagnosis. Peritoneal sac excision and adhesiolysis is the treatment and the outcome is usually satisfactory.
Department of General Surgery, Manipal University, Manipal, India.
Digvijoy
D
Sharma
Rajesh Parameshwaran
RP
Nair
Tushar
T
Dani
Prashanth
P
Shetty
Sclerosing encapsulating peritonitis; Subacute intestinal obstruction