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Case Reports
. 2021 Apr 7;13(4):e14351.
doi: 10.7759/cureus.14351.

Abdominal Cocoon Syndrome: An Extremely Rare Cause of Small Bowel Obstruction

Paraskevi Karona  1 , Evangelos Blevrakis  2 , Pagona Kastanaki  1 , Aggelos Tzouganakis  1 , Miltiades Kastanakis  1
Affiliations
Case Reports

Abdominal Cocoon Syndrome: An Extremely Rare Cause of Small Bowel Obstruction

Paraskevi Karona et al. Cureus. .

Abstract

Abdominal cocoon syndrome or encapsulating peritoneal sclerosis is a rare condition causing small bowel obstruction. It is called cocoon syndrome because of the existence of an abnormal membrane that contains part or the entire small intestine. We present a case of a 49-year-old male, presenting to our department with recurrent episodes of obstructive ileus that did not respond to conservative treatment. He underwent exploratory laparotomy and a thick membrane covering the small bowel loops was found. The membrane was excised and sent for pathological examination. Abdominal cocoon syndrome is an acquired condition caused by an inflammatory process that is not yet completely understood. There are many theories for the pathophysiology of the disease. In most cases, the diagnosis is established during surgery. Complete removal of the membrane is the indicated surgical treatment. In mild cases, when the diagnosis is made preoperatively, conservative treatment should be the first choice.

Keywords: cocoon syndrome; intestinal obstruction.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. CT scan.
CT scan after gastrografin administration revealing distended stomach.
Figure 2
Figure 2. CT scan.
CT scan after gastrografin administration revealing distended small bowel loops.
Figure 3
Figure 3. Intraoperative findings.
By entering the abdominal cavity a thick membrane covering the small intestine is identified.
Figure 4
Figure 4. Intraoperative findings.
A loop completely covered with the membrane.
Figure 5
Figure 5. Intraoperative findings.
The membrane is completely removed.
See this image and copyright information in PMC

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