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Abdominal Cocoon Syndrome: A Laparoscopic Approach
Waqas Aziz1, Yashfeen Malik1, Shahan Haseeb2
1General Surgery, Shifa International Hospital Islamabad, Islamabad, PAK.
Abstract:
Sclerosing encapsulating peritonitis, or abdominal cocoon syndrome (ACS), is a rare cause of intestinal obstruction in which the small bowel is encapsulated by a fibro-collagenous membrane. We present the case of a 29-year-old male who presented to us with acute intestinal obstruction. The imaging performed suggested the presence of ACS. The patient underwent laparoscopic adhesiolysis and the small bowel was released. In cases of recurrent small bowel obstruction, a high index of suspicion is required for the diagnosis of ACS. Computed tomography can be a useful imaging modality, and surgery remains the mainstay of treatment.
Insights
Sclerosing encapsulating peritonitis, or abdominal cocoon syndrome (ACS), is a rare condition causing intestinal obstruction. Laparoscopic surgery successfully treated a patient with ACS, highlighting the need for high diagnostic suspicion in recurrent obstruction cases.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Sclerosing encapsulating peritonitis, known as abdominal cocoon syndrome (ACS), is a rare condition characterized by a fibro-collagenous membrane encapsulating the small bowel.
- It presents as a challenging cause of intestinal obstruction.
Observation:
- A case study of a 29-year-old male presenting with acute intestinal obstruction is detailed.
- Initial imaging suggested the presence of abdominal cocoon syndrome.
Findings:
- The patient underwent successful laparoscopic adhesiolysis, releasing the encapsulated small bowel.
- Computed tomography proved to be a valuable imaging tool for diagnosing ACS.
Implications:
- A high index of suspicion is crucial for diagnosing ACS in patients with recurrent small bowel obstruction.
- Surgical intervention, particularly laparoscopic adhesiolysis, remains the primary treatment modality for abdominal cocoon syndrome.
