Abdominal cocoon as a presenting feature of systemic lupus erythematosus. A rare presentation

Systemic lupus erythematosus (SLE) is a multi-organ disorder, which can involve any system of the body, single, or in combination. In the gastrointestinal tract, it can present as nausea, vomiting, abdominal pain, gastroesophageal reflux, dysphagia, constipation, diarrhea, fecal incontinence, intestinal pseudo-obstruction, perforation, and hemorrhage. Abdominal cocoon or sclerosing-encapsulated peritonitis is a rare cause of intestinal obstruction, resulting from the encasement of variable lengths of bowel by a dense fibrocollagenous membrane that gives the appearance of a cocoon. It is often seen in adolescent girls. We hereby present a case of abdominal cocoon with repeated vomiting and subacute intestinal obstruction as presenting features of SLE in a young girl. The abdominal features responded well to steroids and immunosuppressive therapy.