Abdominal cocoon, the primary form of "sclerosing encapsulating peritonitis," is a rare condition of idiopathic etiology that results in acute or subacute intestinal obstruction due to thick, fibrotic, cocoon-like membrane, partially or totally encasing the bowel loops.
The treatment of abdominal cocoon includes surgery and nutritional support.
Abboud, "Idiopathic sclerosing encapsulating peritonitis: abdominal cocoon," World Journal of Gastroenterology, vol.
Li et al., "Surgical treatment and perioperative management of idiopathic abdominal cocoon: single-center review of 65 cases," World Journal of Surgery, vol.
Abdominal cocoon was first observed by Owtschinnikow in 1907, who called it as peritonitis chronica fibrosa incapsulata at that time, first described and named by Singapore researchers Foo et al .
Diagnosis and treatment of abdominal cocoon: A report of 24 cases.
of patients (%) Bowel thickening 04 (28.5) Stricture * 04 (28.5) Malrotation of gut * 02 (14.0) Ileo-caecal Tuberculosis * 02 (14.0) Abdominal cocoon
* 01 (07.0) Intussussception * 01 (07.0) * Findings suggestive of underlying cause of obstruction Table 7.1: Comparison of X-ray, USG and CT Scan findings Investigations X-Ray(in 63 USG(in 60 CT Scan(in patients) patients) 15 patients) Positive Finding 47 (74.60%) 48(80%) 14(93.33%) Negative Finding 16(25.39%) 12(20%) 1(6.77%) Table 8: Comparison of operative findings with the investigations in 14 patients SI.
In consideration of the abdominal cocoon
and severe abdominal wall adhesion because of previous surgeries and repeat infection, the ablation was performed via a horizontal incision at left side of the abdomen, where the adhesion is the least.
Diagnostic laparoscopy in this era has a major role in the management of rare causes of intestinal obstruction such as abdominal cocoon
Since it was first reported in 1907, the abdominal cocoon
still remains uncommon as a cause of intestinal obstruction.
DISCUSSION: Abdominal cocoon
may be classified into primary or idiopathic and secondary forms .