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Case Reports
. 2021 Dec 11;13(12):e20341.
doi: 10.7759/cureus.20341. eCollection 2021 Dec.

Abdominal Cocoon: A Rare Complication of Peritoneal Dialysis in Chronic Kidney Disease

Fatema Y Mohamed  1 , Yasser H Alharbi  2 , Mohammad N Almutairi  3 , Nawaf A Azi  4 , Alwaleed A Aljreas  3 , Eman J Alkhaldi  2 , Sulaiman H Alanazi  5 , Abdullah T Alanazi  6 , Mohammad S Alzahrany  7 , Ahmed A Alali  8 , Lujain H Alharthi  9 , Rabab K Alkhalifah  10 , Razan M Almarhoun  10 , Hajar M Alkhadhabah  10 , Faisal Al-Hawaj  10
Affiliations
Case Reports

Abdominal Cocoon: A Rare Complication of Peritoneal Dialysis in Chronic Kidney Disease

Fatema Y Mohamed et al. Cureus. .

Retraction in

Expression of concern in

Abstract

The abdominal cocoon is a rare clinical entity characterized by a thick fibrocollagenous membrane encasing the intestinal loops. Despite its rarity, the abdominal cocoon is one of the most serious complications of peritoneal dialysis. We report the case of a 45-year-old man, with end-stage renal disease on peritoneal dialysis resulting from systemic lupus erythematosus, who presented to the emergency department with progressive abdominal pain for the last two weeks. The pain was associated with nausea, vomiting, abdominal distension, and decreased bowel motion. Upon examination, the vital signs were within the normal limits. Abdominal examination revealed a distended abdomen with generalized tenderness. There was evidence of ascites as indicated by the positive shifting dullness test. The bowel sounds were of increased frequency and intensity. The laboratory findings were non-contributory. The patient underwent an abdominal computed tomography scan that demonstrated a cluster of small intestinal loops in the middle of the abdomen with a surrounding thick and calcified membrane. This made the diagnosis of the abdominal cocoon. The patient underwent an operation to resect the fibrocollagenous membrane. The patient reported improvement after the operation. No recurrence was noted after three months of follow-up. Abdominal cocoon is a very rare complication of peritoneal dialysis. The diagnosis of abdominal cocoon should be kept in mind when the physician encounters a patient with peritoneal dialysis who presented with non-specific and unexplained gastrointestinal symptoms.

Keywords: abdominal cocoon; abdominal pain; case report; end-stage renal disease; peritoneal dialysis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Selected axial CT image demonstrates a clustered small intestinal loop with the surrounding thick and calcified membrane (arrows). A localized fluid collection (asterisk) is also noted.
CT: Computed tomography
Figure 2
Figure 2. Histopathological examination of the excised membrane reveals fibrocollagenous tissue.
See this image and copyright information in PMC

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