title: Rare etiology of mechanical intestinal obstruction: Abdominal cocoon syndrome.
abstract: Abdominal cocoon syndrome is a rare cause of intestinal obstruction with unknown etiology. Diagnosis of this syndrome, which can be summarized as the small intestine being surrounded by a fibrous capsule not containing the mesothelium, is difficult in the preoperative period. A 47-year-old male patient was referred to the emergency department with complaints of abdominal pain, nausea, and vomiting for two days. The abdominal computed tomography examination detected dilated small intestinal loops containing air-fluid levels clustered in the left upper quadrant of the abdomen and surrounded by a thick, saclike, contrast-enhanced membrane. During exploratory surgery, a capsular structure was identified in the upper left quadrant with a regular surface that was solid-fibrous in nature. Abdominal cocoon syndrome is a rarely seen condition, for which the preoperative diagnosis is difficult. The combination of physical examination and radiological signs, and the knowledge of "recurrent characteristics of the complaints" that can be learned by a careful history, may be helpful in diagnosis.
authors.affiliation: Yener Uzunoglu, Omer Yalkin, Guner Cakmak, Department of General Surgery, Sakarya University Research and Educational Hospital, 54100 Sakarya, Turkey.
authors.forename: Yener
authors.initials: Y
authors.lastname: Uzunoglu
authors.affiliation: Yener Uzunoglu, Omer Yalkin, Guner Cakmak, Department of General Surgery, Sakarya University Research and Educational Hospital, 54100 Sakarya, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Altintoprak
authors.affiliation: Yener Uzunoglu, Omer Yalkin, Guner Cakmak, Department of General Surgery, Sakarya University Research and Educational Hospital, 54100 Sakarya, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Yalkin
authors.affiliation: Yener Uzunoglu, Omer Yalkin, Guner Cakmak, Department of General Surgery, Sakarya University Research and Educational Hospital, 54100 Sakarya, Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Gunduz
authors.affiliation: Yener Uzunoglu, Omer Yalkin, Guner Cakmak, Department of General Surgery, Sakarya University Research and Educational Hospital, 54100 Sakarya, Turkey.
authors.forename: Guner
authors.initials: G
authors.lastname: Cakmak
authors.affiliation: Yener Uzunoglu, Omer Yalkin, Guner Cakmak, Department of General Surgery, Sakarya University Research and Educational Hospital, 54100 Sakarya, Turkey.
authors.forename: Orhan V
authors.initials: OV
authors.lastname: Ozkan
authors.affiliation: Yener Uzunoglu, Omer Yalkin, Guner Cakmak, Department of General Surgery, Sakarya University Research and Educational Hospital, 54100 Sakarya, Turkey.
authors.forename: Fehmi
authors.initials: F
authors.lastname: Celebi
keywords: Abdominal cocoon syndrome; Adult patient; Intestinal obstruction; Preoperatively diagnosis