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Updated: Jul 3, 2026
04:14
Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Abdominal cocoon: clinical presentation, diagnosis, and management
Debajyoti Mohanty1, Bhupendra Kumar Jain, Juhi Agrawal
1Department of Surgery, Guru Teg Bahadur Hospital, University College of Medical Sciences, Delhi 110 095, India.
Summary
A rare abdominal cocoon causing intestinal obstruction was diagnosed in a teenager using CT scans. Surgical removal of the cocoon, caused by tuberculosis, resolved the obstruction.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Sub-acute intestinal obstruction (SAIO) can present with complex abdominal findings.
- Abdominal cocoon is a rare condition characterized by a fibrous membrane encasing the small intestine.
Observation:
- A 15-year-old female presented with SAIO and a palpable abdominal mass.
- Contrast-enhanced computed tomography (CECT) revealed congregated small bowel loops within a thick membrane, consistent with an abdominal cocoon.
- Laparotomy confirmed a thick membrane encasing the small intestine.
Findings:
- Surgical excision of the abdominal cocoon successfully released the encased small bowel.
- Histopathology of the excised membrane revealed granulomatous inflammation, indicative of tuberculosis.
- The patient's symptoms resolved post-surgery, and she was discharged on anti-tuberculosis medication.
Implications:
- Abdominal cocoon should be considered in the differential diagnosis of SAIO with abdominal lumps, particularly in endemic tuberculosis regions.
- CECT is a valuable diagnostic tool for identifying abdominal cocoons and planning surgical intervention.
- Early diagnosis and surgical management of abdominal cocoon can lead to favorable patient outcomes.
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