Abstract

We have treated two patients with small bowel (abdominal) cocoon who presented with acute and partial small bowel obstruction associated with an abdominal mass. Neither had a history of previous surgery, peritonitis, or prolonged drug therapy. The distinct features of this disease are illustrated. A developmental etiology and a new nomenclature for this disease are proposed, along with a review of the literature.

Highlights

  • Small bowel cocoon is a rare disease of the peritoneum, of obscure origin, seen mostly in children and adolescents

  • It is characterized by the conglomeration of part of or the entire small bowel encased in a dense, white, fibrous membrane resulting in mechanical bowel obstruction

  • We propose that abdominal cocoon be renamed small bowel cocoon as it is more descriptive and meaningful etiologically and clinically

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Summary

Introduction

Small bowel (abdominal) cocoon is a rare disease of the peritoneum, of obscure origin, seen mostly in children and adolescents. It is characterized by the conglomeration of part of or the entire small bowel encased in a dense, white, fibrous membrane resulting in mechanical bowel obstruction. A long-standing incomplete small bowel obstruction precedes the acute episode. No abnormality of intestinal rotation is associated with this entity and surgery can lead to complete recovery. We report our experience with two such children

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