Abdominal Cocoon: An Unusual Cause of Intestinal Obstruction

Hasan Md Abdur Rouf,Mohammad Arman Zahed Basunia,Russel Ahmed Khan Lodi,Shayda Ali,Tapesh Kumar Paul

doi:10.3329/dmcj.v5i1.31437

Hasan Md Abdur Rouf, Mohammad Arman Zahed Basunia + Show 3 more

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https://doi.org/10.3329/dmcj.v5i1.31437

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Journal: Delta Medical College Journal	Publication Date: Feb 4, 2017
License type: CC BY 4.0

Affiliation: Delta State University

Abstract

Abdominal cocoon, the idiopathic form of sclerosing encapsulating peritonitis, is a rare condition of unknown etiology that results in an intestinal obstruction due to total or partial encapsulation of the small bowel by a fibrocollagenous membrane. The early clinical features are nonspecific, are often not recognized and it is difficult to make a definite pre-operative diagnosis. Clinical suspicion may be generated by the recurrent episodes of small intestinal obstruction combined with relevant imaging findings and lack of other plausible etiologies. Surgery is important in the management of this disease. Careful dissection and excision of the thick sac with the release of the small intestine leads to complete recovery in the vast majority of cases. Here a case of abdominal cocoon in a 45 years old male is presented due to its rarity and difficulty in preoperative diagnosis.Delta Med Col J. Jan 2017 5(1): 49-52

Highlights

Abdominal cocoon is a rare condition that refers to total or partial encapsulation of the small bowel by a fibrocollagenous membrane causing clustering of the bowel which was first described by Owtschinnikow in 1907 as “peritonitis chronica fibrosa incapsulata”[1] and subsequently termed “abdominal cocoon” by Foo[2] in 1978
Examination of the abdomen revealed an intra-abdominal mass occupying the upper part of right iliac fossa, right lumbar and umbilical region
On abdominal ultrasonography bowel loops seemed to be dilated having no collection in right iliac fossa

Summary

Introduction

Abdominal cocoon is a rare condition that refers to total or partial encapsulation of the small bowel by a fibrocollagenous membrane causing clustering of the bowel which was first described by Owtschinnikow in 1907 as “peritonitis chronica fibrosa incapsulata”[1] and subsequently termed “abdominal cocoon” by Foo[2] in 1978. The exact cause and pathogenesis of the abdominal cocoon syndrome (or idiopathic encapsulating peritonitis) have not been elucidated though there are several theories. The majority of the cases are reported from tropical and subtropical climate belts of the world and usually occur in female.[3] It commonly presents as intestinal obstruction, weight loss or abdominal mass and in some cases it may be asymptomatic. 2. Resident Surgeon of Surgery, Delta Medical College, Dhaka, Bangladesh.

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Conclusion