Abdominal cocoon in a young man

Abstract

Background: Intestinal obstruction remains a common problem encountered in the surgical emergency, and usually occurs secondary to adhesions, obstructed herniae or tubercular strictures. However, at times, rare causes of obstruction can also be encountered.

Methods: A 24-year-old male patient presented with recurrent episodes of intestinal obstruction that was found to be secondary to an abdominal cocoon on laparotomy.

Results: The patient underwent adhesiolysis of the cocoon, and remains well on a follow-up. Histopathological report of the cocoon wall revealed fibrocollagenic tissues with a mixed inflammatory infiltrate, without any evidence of tuberculosis.

Conclusions: Abdominal cocoon can be a rare cause of intestinal obstruction in male patients. Adhesiolysis of the cocoon membrane releases the obstruction and gives good results.

Keywords: Cocoon; Emergency surgery; Idiopathic; Intestinal obstruction; Laparotomy; Tuberculosis.

Figure 1

CT scan image showing dilated small bowel loops.

Figure 2

Photograph showing the cocoon encasing the bowel loops at the time of laparotomy.