Cocoon carcinomatosa: An unusual cause of intestinal obstruction

Abdominal cocoon, also termed sclerosing encapsulating peritonitis, is an uncommon entity associated with formation of a fibro-collagenous membrane around intestinal loops resulting in intestinal obstruction. Most reported cases are idiopathic, but many other causes have been implicated in cocoon formation, including use of continuous ambulatory peritoneal dialysis, peritoneal tuberculosis, and connective tissue disease. However, peritoneal carcinomatosis is a rarely reported entity that causes this condition. Reported here are two cases of abdominal cocoon secondary to peritoneal carcinomatosis. Both patients presented with intestinal obstruction; one underwent surgery but the other refused surgery.