Abdominal Cocoon Syndrome Secondary to Signet Ring Cell Adenocarcinoma: A Rare Diagnostic Challenge

Abdominal cocoon syndrome, or sclerosing encapsulating peritonitis, is a rare condition characterized by the encasement of the small bowel in a dense fibrocollagenous membrane, often mimicking symptoms of bowel obstruction. Secondary ACS associated with malignancy is exceptionally uncommon.

A 44-year-old man with a history of ascites presented with intractable nausea, vomiting and severe cachexia. The diagnostic process posed significant challenges, requiring advanced imaging and invasive interventions to uncover the underlying malignancy.

This case highlights the diagnostic challenges of secondary abdominal cocoon syndrome, emphasizing the importance of maintaining high clinical suspicion and utilizing advanced diagnostic tools in complex presentations.

Early recognition, advanced imaging, and a multidisciplinary approach are critical to optimizing outcomes in rare and challenging conditions.