Abdominal Cocoon Syndrome: An Extremely Rare Cause of Small Bowel Obstruction
Paraskevi Karona, Evangelos Blevrakis, Pagona Kastanaki, Aggelos Tzouganakis, Miltiades Kastanakis
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.