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Abdominal Cocoon Syndrome as a cause of Intestinal Obstruction: A Case Report

Received: 12 October 2018     Accepted: 5 November 2018     Published: 19 December 2018
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Abstract

Abdominal cocoon syndrome is also known as sclerosing encapsulating peritonitis, characterized by small bowel encapsulation by a fibro-collagenous membrane or “cocoon”. It is a rare cause of intestinal obstruction and has been reported predominantly in adolescent girls living in tropical/subtropical region. The cause and pathogenesis of the condition have not been elucidated. Prolonged administration of practalol, meconium peritonitis, and tuberculous infection of the female genital tract have been incriminated as possible causes. Timely and accurate imaging and diagnosis is important to avoid morbidity and mortality. Preoperative diagnosis is difficult. It is usually diagnosed during surgery. Simple excision of the membrane and lysis of the adhesions produces optimal results. Breaking of adhesions needs to be done carefully; to prevent damage to serosal surface and perforation. This case report is of a 38yr old lady who presented with sub-acute intestinal obstruction that was secondary to an abdominal cocoon and was managed by Laparoscopic surgery in our hospital.

Published in Journal of Surgery (Volume 6, Issue 6)
DOI 10.11648/j.js.20180606.13
Page(s) 159-161
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Abdomen, Cocoon, Intestinal Obstruction, Sclerosing Encapsulating Peritonitis, Subacute Intestinal Obstruction

References
[1] Da Luz MM, Barral SM, Barral CM, Bechara C de S, Lacerda-Filho A. Idiopathic encapsulating peritonitis: report of two cases. Surg Today 2011; 41(12): 1644e8.
[2] Foo KT, Ng KC, Rauff A, Foong WC, Sinniah R. Unusual small intestinal obstruction in adolescent girls: the abdominal cocoon. Br J Surg 1978; 65: 427e30.
[3] Ranganathan S, Abdullah BJJ, Sivanesaratnam V. Abdominal cocoon syndrome. Hong Kong J Radiol 2003; 6: 201e3.
[4] Singh M, Pandey S, Jindal S, Sandhu S. Tubercular abdominal cocoonea rare cause of intestinal obstruction. JSCR 2012; 1: 10.
[5] Xu Ping, Chen Li-Hua, Li You-Ming. Idiopathic sclerosing encapsulating peritonitis (or abdominal cocoon): a report of 5 cases. World J Gastroenterol 2007; 13(26): 3649e51.
[6] Kaushik Robin, Punia RPS, Mohan Harsh, Attri Ashok K. Tuberculous abdominal cocoon e a report of 6 cases and review of the literature. World J Emerg Surg 2006; 1: 8.
[7] George C, Al-Zawe K, Nair S, Cast JE. Computed tomography appearances of sclerosing encapsulating peritonitis. Clin Radiol 2007; 62(8): 732e7.
[8] Narayanan R, Kabra SG, Bhargava BN, Sangal BC. Idiopathic sclerosing encapsulating peritonitis. Lancet 1989; 2: 127e9.
[9] Tannoury JN, Abboud BN. Idiopathic sclerosing encapsulating peritonitis: abdominal cocoon. World J Gastroenterol 2012; 18(17): 1999e2004.
[10] Makam R, Chamany T, Ramesh S, Potluri VK, Varadaraju PJ, Kasabe P. Laparoscopic management of abdominal cocoon. J Minim Access Surg 2008; 4: 15e7.
Cite This Article
  • APA Style

    Balachandran Premkumar, Sayed Mohammed Afsal, Ramamurthee Kannaiyan, Senguttuvan Pandian, Ranjini Ramachandran. (2018). Abdominal Cocoon Syndrome as a cause of Intestinal Obstruction: A Case Report. Journal of Surgery, 6(6), 159-161. https://doi.org/10.11648/j.js.20180606.13

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    ACS Style

    Balachandran Premkumar; Sayed Mohammed Afsal; Ramamurthee Kannaiyan; Senguttuvan Pandian; Ranjini Ramachandran. Abdominal Cocoon Syndrome as a cause of Intestinal Obstruction: A Case Report. J. Surg. 2018, 6(6), 159-161. doi: 10.11648/j.js.20180606.13

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    AMA Style

    Balachandran Premkumar, Sayed Mohammed Afsal, Ramamurthee Kannaiyan, Senguttuvan Pandian, Ranjini Ramachandran. Abdominal Cocoon Syndrome as a cause of Intestinal Obstruction: A Case Report. J Surg. 2018;6(6):159-161. doi: 10.11648/j.js.20180606.13

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  • @article{10.11648/j.js.20180606.13,
      author = {Balachandran Premkumar and Sayed Mohammed Afsal and Ramamurthee Kannaiyan and Senguttuvan Pandian and Ranjini Ramachandran},
      title = {Abdominal Cocoon Syndrome as a cause of Intestinal Obstruction: A Case Report},
      journal = {Journal of Surgery},
      volume = {6},
      number = {6},
      pages = {159-161},
      doi = {10.11648/j.js.20180606.13},
      url = {https://doi.org/10.11648/j.js.20180606.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20180606.13},
      abstract = {Abdominal cocoon syndrome is also known as sclerosing encapsulating peritonitis, characterized by small bowel encapsulation by a fibro-collagenous membrane or “cocoon”. It is a rare cause of intestinal obstruction and has been reported predominantly in adolescent girls living in tropical/subtropical region. The cause and pathogenesis of the condition have not been elucidated. Prolonged administration of practalol, meconium peritonitis, and tuberculous infection of the female genital tract have been incriminated as possible causes. Timely and accurate imaging and diagnosis is important to avoid morbidity and mortality. Preoperative diagnosis is difficult. It is usually diagnosed during surgery. Simple excision of the membrane and lysis of the adhesions produces optimal results. Breaking of adhesions needs to be done carefully; to prevent damage to serosal surface and perforation. This case report is of a 38yr old lady who presented with sub-acute intestinal obstruction that was secondary to an abdominal cocoon and was managed by Laparoscopic surgery in our hospital.},
     year = {2018}
    }
    

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    T1  - Abdominal Cocoon Syndrome as a cause of Intestinal Obstruction: A Case Report
    AU  - Balachandran Premkumar
    AU  - Sayed Mohammed Afsal
    AU  - Ramamurthee Kannaiyan
    AU  - Senguttuvan Pandian
    AU  - Ranjini Ramachandran
    Y1  - 2018/12/19
    PY  - 2018
    N1  - https://doi.org/10.11648/j.js.20180606.13
    DO  - 10.11648/j.js.20180606.13
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 159
    EP  - 161
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20180606.13
    AB  - Abdominal cocoon syndrome is also known as sclerosing encapsulating peritonitis, characterized by small bowel encapsulation by a fibro-collagenous membrane or “cocoon”. It is a rare cause of intestinal obstruction and has been reported predominantly in adolescent girls living in tropical/subtropical region. The cause and pathogenesis of the condition have not been elucidated. Prolonged administration of practalol, meconium peritonitis, and tuberculous infection of the female genital tract have been incriminated as possible causes. Timely and accurate imaging and diagnosis is important to avoid morbidity and mortality. Preoperative diagnosis is difficult. It is usually diagnosed during surgery. Simple excision of the membrane and lysis of the adhesions produces optimal results. Breaking of adhesions needs to be done carefully; to prevent damage to serosal surface and perforation. This case report is of a 38yr old lady who presented with sub-acute intestinal obstruction that was secondary to an abdominal cocoon and was managed by Laparoscopic surgery in our hospital.
    VL  - 6
    IS  - 6
    ER  - 

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Author Information
  • Department of Surgical Gastroenterology and General Surgery, Apollo Speciality Hospital, Chennai, India

  • Department of General and Laparoscopic Surgery, Apollo Speciality Hospital, Chennai, India

  • Department of General Medicine, Apollo Speciality Hospital, Chennai, India

  • Department of Radio Diagnosis, Apollo Speciality Hospital, Chennai, India

  • Department of General Surgery, Apollo Speciality Hospital, Chennai, India

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