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Abdominal cocoon: an unusual presentation of small bowel obstruction

R G Naniwadekar1, S R Kulkarni1, P Bane2

  • 1Consultant, Department of General Surgery, Krishna Institute of Medical Sciences and Research Centre , Maharashtra, India .

Journal of Clinical and Diagnostic Research : JCDR
|April 5, 2014
PubMed

Insights

Abdominal cocoon, a rare condition also known as sclerosing encapsulating peritonitis, involves a membrane covering the bowel. Diagnosis is typically surgical, with treatment focused on membrane resection and adhesion release.

Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Abdominal cocoon, or sclerosing encapsulating peritonitis, is a rare condition characterized by a fibrous membrane encasing the small intestine.
  • This condition often presents with recurrent episodes of small bowel obstruction, necessitating surgical intervention.

Observation:

  • The hallmark presentation is a thick, whitish membrane enveloping bowel loops, leading to its characteristic name.
  • Diagnosis is predominantly intraoperative due to the rarity and non-specific nature of pre-operative symptoms.

Findings:

  • Surgical resection of the encapsulating membrane and lysis of adhesions are the primary treatment modalities.
  • While pre-operative investigations for bowel obstruction are conducted, they do not alter the fundamental surgical management approach.

Implications:

  • Pre-operative workup aids in expediting surgical planning and intervention for patients with suspected abdominal cocoon.
  • Understanding the intraoperative diagnosis and treatment is crucial for managing this rare condition effectively.
Keywords:
Bowel obstructionExploratory laparotomySclerosing encapsulating peritonitis

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