Current Research on Abdominal Cocoon Syndrome: Two Cases of an Anatomical Abnormality
Innovations in Medicine and Medical Research Vol. 2,
Page 120-128
Abstract
Introduction: Idiopathic sclerosing encapsulating peritonitis or abdominal cocoon syndrome (ACS) is a rare anatomical deformity characterized by the partial or complete encasement of the small intestine with fibrotic peritoneum. 193 incidents have been described worldwide. The aim of this study was to present two ACS cases successfully treated at the Surgical Clinic of the Agios Dimitrios General Hospital in Thessaloniki, Greece.
Presentation of Cases: Two men (55 and 54 years old) presented to the emergency department complaining of abdominal pain, distension, constipation, nausea, and vomiting. Neither of these patients had surgical histories. The computed tomography of the first patient showed considerable distension of the small bowel, suggestive of an internal hernia. The second case showed distention of the jejunum with no obvious cause. Both patients underwent emergency surgery. Intraoperatively, we found that a fibrous membrane had completely covered the small intestine of the first patient, and the jejunum and part of the large intestine of the second patient. Adhesiolysis and a partial excision of the membrane were performed in both cases.
Discussion: ACS is a rare cause of small bowel ileus. Although pharmaceutical treatments with immunosuppressants and steroids have been described, surgical treatment is the gold standard.
Conclusion: Preoperative clinical suspicion of this disease can help determine the diagnosis and protect surgeons from intraoperative “surprises.”
Keywords:
- Idiopathic sclerosing encapsulating peritonitis
- abdominal cocoon syndrome
- intestinal obstruction
- case report
How to Cite
- Abstract View: 0 times