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Abdominal cocoon: preoperative diagnosis on CT
Sudipta Mohakud1, Aparna Juneja2, Hira Lal3
1Radiodiagnosis, All India Institute of Medical Sciences Bhubaneswar, Odisha, India.
BMJ Case Reports
|June 3, 2019
Summary
Abdominal cocoon, a rare cause of intestinal obstruction, involves a membrane encasing the small bowel. Contrast-enhanced CT scans aid in early diagnosis, enabling timely surgical intervention for this condition.
Area of Science:
- Gastroenterology
- Radiology
- Surgical Pathology
Background:
- Abdominal cocoon, an idiopathic form of sclerosing encapsulating peritonitis, presents as an unusual cause of intestinal obstruction.
- Clinical diagnosis is often challenging due to non-specific symptoms, delaying treatment.
- Recurrent subacute intestinal obstruction necessitates thorough investigation for underlying causes.
Observation:
- A 23-year-old male presented with recurrent subacute intestinal obstruction.
- Physical examination revealed a hypogastric mass.
- Contrast-enhanced CT scan demonstrated small bowel loops clumped within a membrane-like structure.
Findings:
- Surgical exploration confirmed an abdominal cocoon, requiring membrane incision and separation of small bowel loops.
- CT imaging facilitated accurate preoperative diagnosis, identifying the condition before complete obstruction.
Implications:
- Abdominal cocoon is a rare but significant cause of intestinal obstruction.
- CT scan is vital for early diagnosis, differentiating from secondary causes, and guiding surgical management.
- Prompt diagnosis and intervention can prevent severe complications associated with intestinal obstruction.
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