Abdominal cocoon: report of five cases.

Area of Science:

• Tropical Medicine
• Gastroenterology
• Surgical Pathology

Background:

• Abdominal cocoon, also known as idiopathic sclerosing peritonitis, is a rare condition predominantly found in tropical and subtropical regions.
• It involves the encapsulation of abdominal organs by a fibrous membrane, leading to bowel obstruction.
• While typically seen in adolescent females, its occurrence in other demographics warrants further investigation.

Purpose of the Study:

• To present five cases of abdominal cocoon diagnosed in a rural Kenyan hospital between 1993 and 1998.
• To discuss the operative findings and management strategies for this condition in a tropical setting.
• To explore potential associations with other diseases, such as HIV/AIDS.

Main Methods:

• Retrospective case series analysis of five patients diagnosed with abdominal cocoon.
• Review of surgical findings, including the extent of peritoneal encapsulation and organ involvement.
• Documentation of surgical interventions and patient outcomes.

Main Results:

• Five cases of abdominal cocoon were identified over a six-year period in a rural Kenyan hospital.
• Operative findings revealed varying degrees of peritoneal fibrosis encasing the small bowel.
• One unusual case involved a 42-year-old patient who was subsequently diagnosed with AIDS.

Conclusions:

• Abdominal cocoon, though rare, is a significant cause of intestinal obstruction in tropical regions.
• Management requires surgical intervention, with outcomes dependent on the extent of disease and promptness of treatment.
• The association with AIDS in an adult patient suggests a potential link or increased susceptibility in immunocompromised individuals.