Abdominal Cocoon Syndrome: A Case Report

Meher Angez Rahman; Mizanul Hasan; Nurfizah Nadiah Binti Hj Sulaiman

doi:10.18535/ijsrm/v13i06.mp03

Abstract

Abdominal cocoon syndrome (ACS) is defined as idiopathic partial or total encapsulation of the bowel and other abdominal organ within a fibrocollageneous membrane and considered as a rare cause of small bowel obstruction (1). Also known as primary sclerosing encapsulating peritonitis (SEP). The presence of fibrous membranes that encompasses the intestines forming a sort of butterfly cocoon. Patients often present with symptoms of partial intestinal obstruction, which is challenging to diagnose before laparotomy. Of all the available investigations, the contrast-enhanced computed tomography of the abdomen is the most sensitive, showing a sac like fibrous membrane covering the bowel loops along with the fluid collection. Definitive treatment includes excision and adhesiolysis.

Keywords

Abdominal cocoon syndromeintestinal obstructionsclerosing encapsulating peritonitis

References

Park GH, Lee BC, Hyun DW, Choi JB, Park YM, Jung HJ, et al. Mechanical intestinal obstruction following laparoscopic inguinal hernia repair in a patient with abdominal cocoon syndrome. J Surg Case Rep 2019; 12:1-3. Google Scholar, WorldCat.Google Scholar ↗
Karona P, Blevrakis E, Kastanaki P, Tzouganakis A, Kastanakis M. Abdominal cocoon syndrome: an extremely rare cause of small bowel obstruction. Cureus 2021;13: e14351.Google Scholar ↗
Alsadery HA, Busbait S, AlBlowi A, Alsawidan M, AlBisher HM, Alshammary S. Abdominal cocoon syndrome (idiopathic sclerosing encapsulating peritonitis):an extremely rare cause of small bowel obstruction-two case reports and a review of literature. Front Med 2022; 9:1003775. Google Scholar Cross Ref WorldCat.Google Scholar ↗
Solmaz A, Tokocin M, Arci S, Yigitbas H, Yavuz E, Gulcicek OB, et al. Abdominal cocoon syndrome is a rare cause of mechanical intestinal obstruction: a report of two cases. Am J Case Rep 2015; 16:77-80. Google Scholar CrossRef WorldCat.Google Scholar ↗
Asotibe JC, Zargar P, Achebe I, et all. Secondary abdominal cocoon syndrome due to chronic betablocker use. Cureus 2020;12: e10509. (PMC free article) (Pub med) (Google Scholar)Google Scholar ↗
Yamada S, Tanimoto A, Matsuki Y, et al. Sclerosing encapsulating peritonitis (abdominal cocoon) associated with liver cirrhosis and diffuse large B-cell lymphoma: an autopsy case. Pathol Int 2009; 59: 681-686. (Pub med) (Google Scholar)Google Scholar ↗
Karona P, Blevrakis E, Kastanaki P, et al. Abdominal cocoon syndrome is a rare cause of small bowel obstruction. Cureus 2021;13: e 14351. (PMC free article) (Pub med) (Google Scholar)Google Scholar ↗
Mandavdhare HS, Kumar A, Sharma V, et al. Abdominal cocoon: an enigmatic entity. Trop gastroenterol 2016;37: 156-167. (Google Scholar)Google Scholar ↗
Frost JH, Price EE. Abdominal cocoon: idiopathic sclerosing encapsulating peritonitis. BMJ Case Rep 2015;2015: bcr 2014207524. (PMC free article) (Pub med) (Google Scholar)Google Scholar ↗
Akbulut. Accurate definition and management of idiopathic sclerosing encapsulating peritonitis. World J Gastroenterol 2015; 21:675-687. (PMC free article) (Pub med) (Google Scholar)Google Scholar ↗
Xia J Xie W Chen L et al. Abdominal cocoon with early postoperative small bowel obstruction: a case report and review of literature in China. Medicine (Baltimore) 2018;97: e11102. (PMC free article) (Pub med) (Google Scholar)Google Scholar ↗
Sieck JO, Cowgill R, Larkworthy W. Peritoneal encapsulation and abdominal cocoon: case reports and review of the literature. Gastroenterology 1983; 84:1597-1601 (Pub med) (Google Scholar)Google Scholar ↗
Sharma D, Nair RP, Dani T et al. Abdominal cocoon- a rare cause of intestinal obstruction. Int J Surg Case Rep 2013;4: 955-957. (PMC free article) (Pub med) (Google Scholar)Google Scholar ↗
Hu Q, Shi J, Sun Y. Abdominal cocoon with intestinal perforation: a case report. Front Surg. (2021) 8:7151. doi :10.3389/fsurg.2021.747151 (Pub med abstract) (CrossReff Full Text) (Google Scholar)DOI ↗Google Scholar ↗
Wei B, Wei H-B, Guo W-P, et al. Diagnosis and treatment of abdominal cocoon: a report of 24 cases. Am J Surg 2009;198 :348-353 (Pub med) (Google Scholar)Google Scholar ↗

[refR-1] Park GH, Lee BC, Hyun DW, Choi JB, Park YM, Jung HJ, et al. Mechanical intestinal obstruction following laparoscopic inguinal hernia repair in a patient with abdominal cocoon syndrome. J Surg Case Rep 2019; 12:1-3. Google Scholar, WorldCat.Google Scholar ↗

[refR-2] Karona P, Blevrakis E, Kastanaki P, Tzouganakis A, Kastanakis M. Abdominal cocoon syndrome: an extremely rare cause of small bowel obstruction. Cureus 2021;13: e14351.Google Scholar ↗

[refR-3] Alsadery HA, Busbait S, AlBlowi A, Alsawidan M, AlBisher HM, Alshammary S. Abdominal cocoon syndrome (idiopathic sclerosing encapsulating peritonitis):an extremely rare cause of small bowel obstruction-two case reports and a review of literature. Front Med 2022; 9:1003775. Google Scholar Cross Ref WorldCat.Google Scholar ↗

[refR-4] Solmaz A, Tokocin M, Arci S, Yigitbas H, Yavuz E, Gulcicek OB, et al. Abdominal cocoon syndrome is a rare cause of mechanical intestinal obstruction: a report of two cases. Am J Case Rep 2015; 16:77-80. Google Scholar CrossRef WorldCat.Google Scholar ↗

[refR-5] Asotibe JC, Zargar P, Achebe I, et all. Secondary abdominal cocoon syndrome due to chronic betablocker use. Cureus 2020;12: e10509. (PMC free article) (Pub med) (Google Scholar)Google Scholar ↗

[refR-6] Yamada S, Tanimoto A, Matsuki Y, et al. Sclerosing encapsulating peritonitis (abdominal cocoon) associated with liver cirrhosis and diffuse large B-cell lymphoma: an autopsy case. Pathol Int 2009; 59: 681-686. (Pub med) (Google Scholar)Google Scholar ↗

[refR-7] Karona P, Blevrakis E, Kastanaki P, et al. Abdominal cocoon syndrome is a rare cause of small bowel obstruction. Cureus 2021;13: e 14351. (PMC free article) (Pub med) (Google Scholar)Google Scholar ↗

[refR-8] Mandavdhare HS, Kumar A, Sharma V, et al. Abdominal cocoon: an enigmatic entity. Trop gastroenterol 2016;37: 156-167. (Google Scholar)Google Scholar ↗

[refR-9] Frost JH, Price EE. Abdominal cocoon: idiopathic sclerosing encapsulating peritonitis. BMJ Case Rep 2015;2015: bcr 2014207524. (PMC free article) (Pub med) (Google Scholar)Google Scholar ↗

[refR-10] Akbulut. Accurate definition and management of idiopathic sclerosing encapsulating peritonitis. World J Gastroenterol 2015; 21:675-687. (PMC free article) (Pub med) (Google Scholar)Google Scholar ↗

[refR-11] Xia J Xie W Chen L et al. Abdominal cocoon with early postoperative small bowel obstruction: a case report and review of literature in China. Medicine (Baltimore) 2018;97: e11102. (PMC free article) (Pub med) (Google Scholar)Google Scholar ↗

[refR-12] Sieck JO, Cowgill R, Larkworthy W. Peritoneal encapsulation and abdominal cocoon: case reports and review of the literature. Gastroenterology 1983; 84:1597-1601 (Pub med) (Google Scholar)Google Scholar ↗

[refR-13] Sharma D, Nair RP, Dani T et al. Abdominal cocoon- a rare cause of intestinal obstruction. Int J Surg Case Rep 2013;4: 955-957. (PMC free article) (Pub med) (Google Scholar)Google Scholar ↗

[refR-14] Hu Q, Shi J, Sun Y. Abdominal cocoon with intestinal perforation: a case report. Front Surg. (2021) 8:7151. doi :10.3389/fsurg.2021.747151 (Pub med abstract) (CrossReff Full Text) (Google Scholar)DOI ↗Google Scholar ↗

[refR-15] Wei B, Wei H-B, Guo W-P, et al. Diagnosis and treatment of abdominal cocoon: a report of 24 cases. Am J Surg 2009;198 :348-353 (Pub med) (Google Scholar)Google Scholar ↗