Abstract
BackgroundTuberculous abdominal cocoon is an uncommon manifestation of abdominal tuberculosis. As a rare clinical entity, it is often encountered unexpectedly in patients with small intestinal obstruction. Here we presented a rare case of tuberculous abdominal cocoon which was suspected to be peritoneal carcinomatosis and was finally diagnosed by laparoscopy.Case presentationA 47-year-old man developed small intestinal obstruction and massive ascites that did not resolve with conservative management. Surgical exploration revealed a fibrous sheath covering the small-bowel, and pathologic assessment of biopsies confirmed intra-abdominal tuberculous infection. After antituberculosis therapy, the ascites has greatly diminished and the patient was functioning normally.ConclusionPreoperative diagnosis of tuberculous abdominal cocoon is a true challenge. Early diagnostic peritoneal biopsy should be recommended and surgery is usually unnecessary if definitive diagnosis can be made.
Highlights
ConclusionPreoperative diagnosis of tuberculous abdominal cocoon is a true challenge. Early diagnostic peritoneal biopsy should be recommended and surgery is usually unnecessary if definitive diagnosis can be made
Tuberculous abdominal cocoon is an uncommon manifestation of abdominal tuberculosis
Abdominal cocoon can be classified as primary or secondary according to the etiology [2, 3]
Summary
Though various biochemical parameters and characteristic radiological findings of CT scan play a major role in establishing the diagnosis of tuberculous abdominal cocoon, preoperative diagnosis is a true challenge.
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