A Rare Cause of Intestinal Obstruction: Case Report of an Abdominal Cocoon Syndrome in a Middle Aged Man from the Mediterranean Region

Abstract

1.1. Introduction: Abdominal cocoon syndrome is a rare condition that refers to total or partial encapsulation of the small intestines leading to recurrent bowel obstruction. It usually affects young ladies from tropical and subtropical area. 1.2. Methods: we report a middle aged man, from the Mediterranean region, presenting with small bowel obstruction, with history of recurrent similar episode. 1.3. Results: after failure of conservative treatment, surgical exploration showed a thick fibrous peritoneal membrane wrapping the small bowel in a concentric fashion with some adhesions. The pathology of this resected fibrous membrane confirmed the diagnosis of an abdominal cocoon syndrome. 1.4. Conclusion: From the atypical presentation of our case, we can conclude that though rare, this condition must be kept in mind when considering the differential diagnosis of idiopathic intestinal obstruction in any adult and therefore the decision of a surgical exploration should not be differed in the appropriate context, especially in the light of the condition’s benign nature and favorable prognosis. 1.5. Background: Abdominal cocoon syndrome is a rare condition that refers to total or partial encapsulation of the small intestines by a fibro-collagenous membrane with local inflammatory infiltrate leading to acute, subacute or chronic bowel obstruction [1]. It also has been described as “encapsulating peritoneal sclerosis”, “sclerosing encapsulating peritonitis” and in Latin “peritonitis chronica fibrosaincapsulata” [1, 2]