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Case Reports
. 2019 Mar 26;32(2):227-228.
doi: 10.1080/08998280.2018.1551683. eCollection 2019 Apr.

Cocoon abdomen after chronic peritoneal dialysis

Philip Edmundson  1 , Claire Adkins  1 , Bruce Smith  1
Affiliations
Case Reports

Cocoon abdomen after chronic peritoneal dialysis

Philip Edmundson et al. Proc (Bayl Univ Med Cent). .

Abstract

A 66-year-old man presented with nausea, vomiting, and ascites. At laparotomy, an extensive fibrosis of the peritoneum was found to encase the bowel in a cocoon-like fashion. A meticulous dissection was undertaken to strip this encapsulating membrane from the bowel. Histologic study of the excised tissue disclosed extensive hyalinized fibroconnective tissue.

Keywords: Ascites; bowel obstruction; encapsulating peritoneal sclerosis; fibrosis; hyalinized fibroconnective tissue; peritoneal dialysis.

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Figures

Figure 1.
Figure 1.
(a) CT scan showing thickened peritoneum and calcifications. (b) Entrance to the abdomen with a cocoon-like membrane. (c) Loops of bowel visible underneath the encapsulating membrane. (d) Stripping of the encapsulating membrane. Note the tanned leather appearance of the viscera.
Figure 2.
Figure 2.
(a) Bowel free from encapsulating sclerosis. (b) Representative samples of specimen sent to pathology.
See this image and copyright information in PMC

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