Abdominal cocoon - A rare cause of intestinal obstruction

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Abstract

INTRODUCTION Abdominal cocoon syndrome is characterized by small bowel encapsulation by a fibro-collagenous membrane or "cocoon". It is a rare cause of intestinal obstruction. PRESENTATION OF CASE A 42-year old man presented with sub-acute intestinal obstruction. Intra-operatively, the entire small bowel was found to be encapsulated in a dense fibrous sac. The peritoneal sac was excised, followed by lysis of the inter-loop adhesions. Postoperative recovery was unremarkable. DISCUSSION Most patients with abdominal cocoon syndrome present with features of recurrent acute or chronic small bowel obstruction secondary to kinking and/or compression of the intestines within the constricting cocoon. An abdominal mass may also be present due to an encapsulated cluster of dilated small bowel loops. CONCLUSION Abdominal cocoon is a rare condition causing intestinal obstruction and diagnosis requires a high index of suspicion because of the nonspecific clinical picture. CECT of the abdomen is a useful radiological tool to aid in preoperative diagnosis. Peritoneal sac excision and adhesiolysis is the treatment and the outcome is usually satisfactory. © 2013 The Authors.

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Sharma, D., Nair, R. P., Dani, T., & Shetty, P. (2013). Abdominal cocoon - A rare cause of intestinal obstruction. International Journal of Surgery Case Reports, 4(11), 955–957. https://doi.org/10.1016/j.ijscr.2013.08.004

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