Abdominal Cocoon Presenting As Subacute Intestinal Obstruction

Area of Science:

• Gastroenterology
• Surgical Pathology
• Medical Imaging

Background:

• Abdominal cocoon is a rare condition characterized by a fibro-collagenous membrane enveloping the small intestine.
• Subacute intestinal obstruction is a common surgical presentation, but its association with abdominal cocoon is infrequent.
• Partial midgut malrotation is a congenital anomaly that can predispose to various gastrointestinal complications.

Observation:

• A patient presented with symptoms suggestive of subacute intestinal obstruction.
• Clinical examination and computed tomography (CT) confirmed the presence of an abdominal cocoon.
• The patient had a history of partial midgut malrotation, a potential contributing factor.

Findings:

• The abdominal cocoon was surgically excised, and adhesions were lysed.
• Post-operative recovery was uneventful, with complete resolution of obstruction symptoms.
• Histopathological examination confirmed the fibro-collagenous nature of the membrane.

Implications:

• This case highlights the importance of considering abdominal cocoon in the differential diagnosis of subacute intestinal obstruction, especially in patients with pre-existing conditions like midgut malrotation.
• The successful surgical management underscores the efficacy of laparotomy and adhesiolysis for this rare condition.
• Adding this case to the literature contributes to a better understanding of the idiopathic abdominal cocoon and its clinical manifestations.