Abdominal cocoon syndrome: preoperative diagnostic criteria, good clinical outcome with medical treatment and review of the literature

Abstract

Sclerosing encapsulating peritonitis, or abdominal cocoon syndrome, was described firstly in young adolescent girls. It is characterized by a thick fibrotic peritoneum that wraps the bowel in a concertina-like fashion with some adhesions. We report a man with intermittent intestinal obstruction and an abdominal cocoon encasing the small bowel. Our patient had no history of peritonitisor tuberculosis. We think he had primary abdominal cocoon syndrome. To the best of our knowledge, very few male patients have been reported in the medical literature as developing this condition. We treated the patient with drug therapy, including steroidand mycophenolate mofetil, and a liquid diet program, without surgical operation. He was symptom-free on follow-up over a period of 11 months.