Abdominal Cocoon Syndrome

Gadhire, Minakshi; Singh, Mandeep; Joshi, Mohan

doi:10.14260/jemds/473

Cited by 5 publications

(13 citation statements)

References 12 publications

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“…Primary SEP is also named idiopathic SEP or cocoon syndrome. The term cocoon syndrome was first introduced by Foo in 1978 [ 4 - 6 ]. The cause of the disease remains unknown.…”

Section: Discussionmentioning

confidence: 99%

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

Karona

Blevrakis

Kastanaki

et al. 2021

Cureus

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Abdominal cocoon syndrome or encapsulating peritoneal sclerosis is a rare condition causing small bowel obstruction. It is called cocoon syndrome because of the existence of an abnormal membrane that contains part or the entire small intestine. We present a case of a 49-year-old male, presenting to our department with recurrent episodes of obstructive ileus that did not respond to conservative treatment. He underwent exploratory laparotomy and a thick membrane covering the small bowel loops was found. The membrane was excised and sent for pathological examination. Abdominal cocoon syndrome is an acquired condition caused by an inflammatory process that is not yet completely understood. There are many theories for the pathophysiology of the disease. In most cases, the diagnosis is established during surgery. Complete removal of the membrane is the indicated surgical treatment. In mild cases, when the diagnosis is made preoperatively, conservative treatment should be the first choice.

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“…Primary SEP is also named idiopathic SEP or cocoon syndrome. The term cocoon syndrome was first introduced by Foo in 1978 [ 4 - 6 ]. The cause of the disease remains unknown.…”

Section: Discussionmentioning

confidence: 99%

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

Karona

Blevrakis

Kastanaki

et al. 2021

Cureus

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“…[1][2][3][4][5]11,18,30 Patients with secondary SEP warrant investigations to confirm the presence of predisposing conditions; these should include measurements of erythrocyte sedimentation rate, sputum tests for tuberculosis, ascetic fluid tests for adenosine deaminase levels, examinations for suspected abdominal tuberculosis and, in some cases, laparoscopies and biopsies. 1,2,35,36 Similar investigations would be required to rule out other possible diagnoses 24 including autoimmune conditions or pelvic ovarian inflammatory pathologies. [1][2][3][4] Other differential diagnoses include retractile mesenteritis, sclerosing malignant lymphomas, malignant primary mesenteric tumours and other metastatic neoplasms.…”

Section: Differential Diagnosismentioning

confidence: 99%

“…2 Even though laparoscopies may have both diagnostic and therapeutic purposes, few reports indicate this role clearly. 2,35,[42][43][44] Technically, laparoscopies may be challenging in patients with an advanced abdominal cocoon, such as those with type III SEP. There is a potential risk of gut injury during the trocar insertion and separation and resection of the membrane from the underlying intestine.…”

Section: Differential Diagnosismentioning

confidence: 99%

“…[1][2][3][4][5][6]16,39,44 Predisposing factors that enhance the risk of a postoperative obstruction include significant manipulation of the gut, oedema and prolonged duration of the operation. 2,5,35 Several methods can be employed to reduce the incidence of postoperative intestinal obstruction, including intestinal intubation through the orifice of the appendix in patients with type II or III SEP, the use of steroids to reduce oedema, intestinal stasis or bacterial translocation and somatostatin administration to reduce secretion and intestinal distension. [1][2][3]45 Inserting long intestinal tube splinting may prevent a potential obstruction; thus, it would be wise to fix the bowel in a favourable position.…”

Section: Postoperative Complicationsmentioning

confidence: 99%

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Sclerosing Encapsulating Peritonitis: Review

Machado

2016

SQUMJ

108

182

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Sclerosing encapsulating peritonitis (SEP) is a rare chronic inflammatory condition of the peritoneum with an unknown aetiology. Also known as abdominal cocoon, the condition occurs when loops of the bowel are encased within the peritoneal cavity by a membrane, leading to intestinal obstruction. Due to its rarity and non-specific clinical features, it is often misdiagnosed. The condition presents with recurrent episodes of small bowel obstruction and can be idiopathic or secondary; the latter is associated with predisposing factors such as peritoneal dialysis or abdominal tuberculosis. In the early stages, patients can be managed conservatively; however, surgical intervention is necessary for those with advanced stage intestinal obstruction. A literature review revealed 118 cases of SEP; the mean age of these patients was 39 years and 68.0% were male. The predominant presentation was abdominal pain (72.0%), distension (44.9%) or a mass (30.5%). Almost all of the patients underwent surgical excision (99.2%) without postoperative complications (88.1%).

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“…those patients with severe signs of intestinal obstruction, the most appropriate procedure consists of adhesiolysis and excision of the membrane that encapsulates the intestinal surface, with a low recurrence risk [1] and satisfactory long-term results [1,6,7]. A limited number of case reports have successfully described membrane excision and laparoscopic adhesiolysis [8,9]. To avoid complications, such as leakage of anastomosis and short bowel syndrome, in patients with sclerosing peritonitis, intestinal resection is indicated only when necrosis develops [10].…”

Section: Discussionmentioning

confidence: 99%

Cocoon Syndrome: A Rare Entity

Diaz¹,

Chacón²,

Vílchez

2017

J Curr Surg

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Sclerosing encapsulating peritonitis (SEP) is an uncommon condition characterized by the encasement of small bowel due to a thick fibrotic coverage. This entity is usually related to several diseases, highlighting among them the peritoneal dialysis, and less frequent is the primary or idiopathic peritoneal sclerosis or cocoon syndrome. SEP is clinically variable, depending on the severity and duration of the disease, the underlying causes and the patient's immune status. The most common presentation is intestinal obstruction. It is rarely presented as a complication such as enterocutaneous fistulas, intestinal necrosis and malnutrition. Intestinal perforation is quite uncommon in patients with SEP. We present a case of cocoon syndrome in a 67-year-old man and describe his clinical onset, radiology and anatomical pathology findings.

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Abdominal Cocoon Syndrome

Cited by 5 publications

References 12 publications

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

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

Sclerosing Encapsulating Peritonitis: Review

Cocoon Syndrome: A Rare Entity

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