Rare etiology of mechanical intestinal obstruction: Abdominal cocoon syndrome

Abstract

Abdominal cocoon syndrome is a rare cause of intestinal obstruction with unknown etiology. Diagnosis of this syndrome, which can be summarized as the small intestine being surrounded by a fibrous capsule not containing the mesothelium, is difficult in the preoperative period. A 47-year-old male patient was referred to the emergency department with complaints of abdominal pain, nausea, and vomiting for two days. The abdominal computed tomography examination detected dilated small intestinal loops containing air-fluid levels clustered in the left upper quadrant of the abdomen and surrounded by a thick, saclike, contrast-enhanced membrane. During exploratory surgery, a capsular structure was identified in the upper left quadrant with a regular surface that was solid-fibrous in nature. Abdominal cocoon syndrome is a rarely seen condition, for which the preoperative diagnosis is difficult. The combination of physical examination and radiological signs, and the knowledge of "recurrent characteristics of the complaints" that can be learned by a careful history, may be helpful in diagnosis.

Abdominal Cocoon With Intestinal Perforation: A Case Report

“…Primary abdominal cocoon disease is majorly caused by embryo body curling, abnormal mesoderm differentiation, and intestinal dorsal mesenteric dysplasia during the embryonic period. It is often accompanied by omentum absence, gastrocolic ligament absence, intestinal or colonic malrotation, visceral transposition, cryptorchidism, hernia, and other diseases (10). The causes of the secondary abdominal cocoon are as follows: (1) Abdominal microenvironment changes: an abdominal and pelvic infection caused by various reasons, history of abdominal surgery, longterm peritoneal dialysis, and malignant tumor, etc.…”

Abdominal cocoon syndrome with enigmatic etiology

“…Similar management was followed in our case. 6 Number of factors has been attributed to sclerosing encapsulating peritonitis. One such is the use of povidone iodine after colorectal surgeries and two such patients have developed sclerosing encapsulating peritonitis.…”

Idiopathic cocoon abdomen with congenital colon malrotation: a case report and review of the literature

“…In addition, reasonable diet and good living habits can effectively prevent the aggravation of symptoms. For patients with severe the liver can be seen, multiple gas in the intestine can be seen, accompanied by gas and liquid level symptoms, surgical treatment is the most effective method [17,18].…”