Abdominal cocoon syndrome; a rare etiology of intestinal obstruction; a case report

Abstract

Introductionand importance: The abdominal cocoon is a rare entity of intestinal obstruction. The exact etiopathogenesis of this condition is unknown. Most patients presented with signs and symptoms of intestinal obstruction. Radiological investigations such as abdominal ultrasonography and computed tomography are crucial to evaluate and diagnose abdominal cocoon syndrome, while most cases are usually identified intraoperatively. Case presentationA 32-year-old male patient presented to our hospital with three days of left iliac fossa pain that was associated with multiple vomiting episodes and bowel habits alterations. Physical examination showed a distended abdomen with generalized tenderness. Laboratory investigations showed abnormal values. A plain abdominal X-ray revealed multiple air-fluid levels. Then abdominal CT was performed, and the clinical picture was consistent with small bowel obstruction. So, diagnostic laparoscopy was decided after the conservative management plan failed, during which a cocoon sac was detected intraoperatively. The resected specimen was sent for histopathological studies. The postoperative period was uneventful. Clinical discussionAbdominal cocoon syndrome is an unusual cause of abdominal obstruction that can be categorized surgically into four types. It is considered a life-threatening surgical emergency. The clinical features of abdominal cocoon syndrome include those of intestinal obstruction. Radiological tools aid in the diagnosis demonstration but the definitive diagnosis is achieved by laparotomy and histopathology. ConclusionDue to the rare etiologic origin of abdominal cocoon syndrome, we report the case of a 32-year-old male patient with left iliac fossa pain, found to be caused by detected abdominal cocoon syndrome.