Abdominal Cocoon Syndrome: An Extremely Rare Cause of Small Bowel Obstruction

Karona, Paraskevi; Blevrakis, Evangelos; Kastanaki, Pagona; Tzouganakis, Aggelos; Kastanakis, Miltiades

doi:10.7759/cureus.14351

Cited by 16 publications

(35 citation statements)

References 8 publications

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“…An additional abdominal cavity membrane report has been described in the literature as encapsulating peritoneal sclerosis or sclerosing encapsulating peritonitis (SEP) [7]. This disease can be either primary or secondary [1]. The primary SEP is the one named idiopathic SEP or ACS; secondary SEP is considered acquired and associated with diverse abdominal conditions.…”

Section: Historical Datamentioning

confidence: 99%

“…Conservative management includes nil per mouth, nasogastric tube and enteral or parenteral nutrition [4,7,11]. Patient showing amelioration with this approach could be treated on a chronic basis with medications, such as colchicine, steroids and immunosuppressants [1,16].…”

Section: Differential Diagnosismentioning

confidence: 99%

“…Chronic symptoms are abdominal tension, changes in bowel habits, mild abdominal pain and non-frequently anorexia and weight loss [19]. Abdominal ascites might be detected in longstanding cases [1]. Infrequently present chronic constipation, anorexia, weight loss, intrabdominal masses, perforation or ischemia-related necrosis [14].…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Данный клинический случай демонстрирует клинические, рентгенологические и МРТпризнаки синдрома «абдоминального кокона» у беременной пациентки. Abdominal cocoon syndrome (ACS) is a rare condition causing small bowel obstruction; it may present the first time in an emergency without prior significant medical history [1,2]. ACS, also known as sclerosing peritonitis, is generally regarded as a chronic condition.…”

mentioning

confidence: 99%

“…The small bowel is partially or totally encased by a thick fibro-collagenous membrane that gives a cocoon-like appearance [3]. Other studies report that ACS is an acquired condition caused by an inflammatory process that is not yet completely understood [1].…”

mentioning

confidence: 99%

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Abdominal Cocoon Syndrome in a 13-Weeks Pregnant Woman

Palacio-Lopez¹,

Garcia-Blanco²,

GonzalezHermosillo³

et al. 2021

Rejr

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ncapsulating peritoneal sclerosis, also known as abdominal Cocoon syndrome (ACS) is a rare condition presenting with small-bowel obstruction due to a thick fibrous membrane encasing portions of the intestine. We present the case of a 29-years-old pregnant woman referring to abdominal pain in the last three days. Her past medical and surgical history was unremarkable, and she had never complained of similar symptoms ever before; she had no history of previous abdominal operations or medication. On clinical examination, the abdomen was tender and distended; the patient was pregnant; the US was ordered, and analysis revealed a 13-weeks old fetus.This report aimed to evaluate the radiological and clinical characteristic of ACS in a pregnant patient using MRI.

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Section: Historical Datamentioning

confidence: 99%

Section: Differential Diagnosismentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Abdominal Cocoon Syndrome in a 13-Weeks Pregnant Woman

Palacio-Lopez¹,

Garcia-Blanco²,

GonzalezHermosillo³

et al. 2021

Rejr

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Abdominal cocoon syndrome, a rare and interesting cause of intestinal obstruction: A case report

Menberu,

Guteta,

Bekele

et al. 2024

Clinical Case Reports

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Key Clinical MessageAbdominal cocoon syndrome is a rare cause of bowel obstruction, with variable presentation. It needs a high index of suspicion for diagnosis. Surgical management with the release of adhesions is the preferred option for a healthy bowel. Iatrogenic bowel perforation is a possibility during bowel manipulation and the release of thick fibrous adhesions resulting in bowel resection.AbstractAbdominal cocoon syndrome, also known as encapsulating peritoneal sclerosis, is a rare cause of intestinal obstruction in which the small intestine may be entirely or partially wrapped in a thick sac of fibrous tissue that resembles a cocoon. We present a male Ethiopian patient, 60 years of age, who had a 6‐day history of symptoms of intermittent intestinal obstruction. Before his current presentation, he had a 6‐month history of sporadic vomiting and periodic abdominal pain. These symptoms would go away on their own. An exploratory laparotomy was performed for the preoperative diagnosis of small intestine obstruction secondary to primary small bowel volvulus after a plain abdomen x‐ray confirmed the small bowel obstruction diagnosis. But during surgery, we discovered something unexpected: a mass formed by the encasing membrane over the small bowel. En bloc resection of the mass and distal ileum with ileo‐transverse anastomosis was performed. The patient was discharged after 5 days of an uneventful post‐operative stay. The morbidity and mortality of this rare instance can be decreased by awareness, prompt diagnosis, and appropriate intervention. We discuss diagnostic and therapeutic challenges encountered during the management of this patient.

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