scholarly journals Abdominal Cocoon Syndrome: Two Cases of an Anatomical Abnormality

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Apostolos Sovatzidis ◽  
Eirini Nikolaidou ◽  
Anastasios Katsourakis ◽  
Iosif Chatzis ◽  
George Noussios
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Gold Standard ◽  
Clinical Suspicion ◽  
Internal Herniation ◽  
Computed Tomography Scan ◽  
Abdominal Cocoon ◽  
Encapsulating Peritonitis ◽  
Surgical Clinic ◽  
Tomography Scan

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 cases have been described worldwide. The aim of this study is to present two cases of ACS 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 any previous operations. The computed tomography scan of the first patient showed considerable distension of the small bowel, suggestive of internal herniation. The second case showed distention of the jejunum with no obvious cause. Both patients underwent emergency surgery. Intraoperatively, it was 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 partial excision of the membrane were performed in both cases.Discussion. ACS is a rare cause of small bowel obstruction. Although conservative management with immunosuppressants and steroids has 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”.

scholarly journals Abdominal Cocoon: An Unusual Cause of Intestinal Obstruction

2017 ◽  
Vol 5 (1) ◽  
pp. 49-52
Author(s):  
Tapesh Kumar Paul ◽  
Russel Ahmed Khan Lodi ◽  
Shayda Ali ◽  
Mohammad Arman Zahed Basunia ◽  
Hasan Md Abdur Rouf
Keyword(s):  
Small Intestine ◽  
Intestinal Obstruction ◽  
Rare Condition ◽  
Complete Recovery ◽  
Clinical Suspicion ◽  
Unknown Etiology ◽  
Imaging Findings ◽  
Abdominal Cocoon ◽  
Small Intestinal ◽  
Encapsulating Peritonitis

Abdominal cocoon, the idiopathic form of sclerosing encapsulating peritonitis, is a rare condition of unknown etiology that results in an intestinal obstruction due to total or partial encapsulation of the small bowel by a fibrocollagenous membrane. The early clinical features are nonspecific, are often not recognized and it is difficult to make a definite pre-operative diagnosis. Clinical suspicion may be generated by the recurrent episodes of small intestinal obstruction combined with relevant imaging findings and lack of other plausible etiologies. Surgery is important in the management of this disease. Careful dissection and excision of the thick sac with the release of the small intestine leads to complete recovery in the vast majority of cases. Here a case of abdominal cocoon in a 45 years old male is presented due to its rarity and difficulty in preoperative diagnosis.Delta Med Col J. Jan 2017 5(1): 49-52

scholarly journals Tuberculous Abdominal cocoon in childern– A Single Centre Study in remote area in northern India

2017 ◽  
Vol 90 (2) ◽  
pp. 179-184 ◽  
Author(s):  
Rikki Singal ◽  
Satyashree B ◽  
Amit Mittal ◽  
Bhanu Pratap Sharma ◽  
Samita Singal ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Medical Sciences ◽  
Abdominal Cocoon ◽  
Northern India ◽  
Single Centre Study ◽  
Encapsulating Peritonitis ◽  
Operative Findings ◽  
A Prospective Study ◽  
Tomography Scan

Background. Amongst the numerous causes of intestinal obstruction listed in the literature, sclerosing encapsulating peritonitis also called Abdominal Cocoon (AC) is one of the rarest entities. Its characteristic feature is a thick fibrotic membrane encasing varying lengths of the small and large gut in a cocoon. In India, there is an increasing incidence of tuberculosis, especially in the rural areas.Aims and objectives. The aim of this study was to investigate the clinical presentation and evaluate the operative findings of tuberculous AC. We also evaluated the outcomes and response to anti tuberculous treatment (ATT) in all the patients diagnosed with this condition.Material and methods. This study was carried out at M.M. Institute of Medical Sciences and Research, Mullana, Ambala, India between April 2013 – March 2016 in the Department of Pediatric Surgery. This is a prospective study. A total of 17 patients diagnosed with abdominal cocoon secondary to tuberculosis have been included in the study.Results. A total of 17 patients presented to the emergency ward with features of acute intestinal obstruction. The average age was 15.3 years (range 9 years to 16 years). There were 14 females and 3 males. All patients presented with abdominal pain, bilious vomiting, constipation and abdominal distention. The patients were operated in our hospital and relieved of their obstruction. Based on their operative findings and after histopathological confirmation, patients were given ATT. In the follow-up, all patients did well, without recurrence of tuberculosis or intestinal obstruction. Conclusion. Tuberculosis as a cause of childhood AC is rather common in developing countries and is potentially a fatal condition. A strong clinical suspicion, sonographic and computed tomography scan findings help establish a pre-operative diagnosis. Tuberculous AC has a strong prevalence in females.  Surgery is the mainstay of treatment followed by anti-tuberculous drugs.

scholarly journals Acute Small Bowel Perforation Caused by Obstruction of a Novel Tag-Less AgileTM Patency Capsule

2018 ◽  
Vol 12 (2) ◽  
pp. 337-343 ◽  
Author(s):  
Katsuji Sawai ◽  
Takanori Goi ◽  
Yumi  Takegawa ◽  
Yoshihiko Ozaki ◽  
Seiichi  Taguchi ◽  
...  
Keyword(s):  
Small Bowel ◽  
Bowel Perforation ◽  
Pathological Examination ◽  
Small Bowel Perforation ◽  
Computed Tomography Scan ◽  
Patency Capsule ◽  
Severe Peritonitis ◽  
Transmural Inflammation ◽  
Multiple Ulcers ◽  
Tomography Scan

A 74-year-old man visited our hospital complaining of abdominal pain. An abdominal computed tomography scan showed multiple wall thickness of the small bowel. Capsule endoscopy was recommended for further evaluation, and patency capsule examination was performed. Eighteen hours after patency capsule ingestion, he experienced small bowel perforation with severe peritonitis caused by intestinal pressure rising because of the patency capsule trapped in his terminal ileum. An ileocolic resection was performed, including the removal of the sclerotic ileum as an emergency surgery. A pathological examination showed transmural inflammation and multiple ulcers with perforation of the small intestine, consistent with Crohn’s disease. Here, we report a rare and valuable case of novel tag-less AgileTM patency capsule (Given Imaging Ltd., Yoqneam, Israel) retention leading to small bowel perforation.

scholarly journals Difficult to Diagnose the Cause of Intestinal Obstruction due to Abdominal Cocoon Syndrome

2021 ◽  
Author(s):  
Cemal Ulusoy ◽  
Andrej Nikolovski ◽  
Nazım Öztürk
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Abdominal Mass ◽  
Clinical Signs ◽  
Rare Condition ◽  
Abdominal Cocoon ◽  
Sclerosing Encapsulating Peritonitis ◽  
Encapsulating Peritonitis ◽  
Palpable Abdominal Mass

Abdominal cocoon syndrome (sclerosing encapsulating peritonitis) is a rare condition associated with clinical signs of intestinal dysfunction, episodes of small bowel obstruction and sometimes a palpable abdominal mass. We present the case of a 46-year-old male patient with clinical signs of intestinal obstruction caused by primary sclerosing encapsulating peritonitis.

scholarly journals Small bowel cancer diagnosis: role of nuclear magnetic resonance

2015 ◽  
Vol 9 (3) ◽  
Author(s):  
Alessandro Morotti ◽  
Dario Gned ◽  
Leonardo Di Martino ◽  
Claudia Vaccheris ◽  
Salvatore Lia ◽  
...  
Keyword(s):  
Nuclear Magnetic Resonance ◽  
Magnetic Resonance ◽  
Small Bowel ◽  
High Sensitivity ◽  
Modern Medicine ◽  
Bowel Cancer ◽  
Computed Tomography Scan ◽  
Tomography Scan ◽  
Nuclear Magnetic

The diagnosis of small intestine tumors is challenging. Even in the era of modern medicine, standard approaches including echography, computed tomography-scan and conventional endoscopy are unable to reveal small bowel lesions. Video-capsule has substantially improved the evaluation of small bowel; however this procedure cannot be proposed to all patients and in particular to those experiencing intestine sub-occlusion. Nuclear magnetic resonance (NRM) of the abdomen is an additional diagnostic approach that offers high sensitivity in the identification of small bowel lesions. Here, we describe a case of small bowel neoplasia indentified with NRM of the abdomen.

scholarly journals Case of Incarcerated Femoral Hernia Treated with Laparoscopic Surgery after Groin Hernia Repair

2021 ◽  
pp. 35-40
Author(s):  
Yuki Tsuchiya ◽  
Hirotaka Momose ◽  
Kazumasa Kure ◽  
Hisashi Ro ◽  
Rina Takahashi ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Small Bowel ◽  
Femoral Hernia ◽  
Groin Hernia ◽  
Femoral Vein ◽  
Computed Tomography Scan ◽  
Left Groin ◽  
Femoral Ring ◽  
Necrotic Bowel ◽  
Tomography Scan

An 81-year-old man was brought to our hospital due to a suspicion of left incarcerated femoral hernia. He was previously diagnosed with incarcerated left groin hernia and was treated using the mesh plug method 1 month back at another hospital. Abdominal computed tomography scan revealed small bowel obstruction, incarcerated bowel, and compression of the left femoral vein. Thus, the patient was diagnosed with incarcerated femoral hernia. An emergency laparoscopic surgery was then performed, and we found that the small bowel was incarcerated into the let femoral ring and was necrotic. However, there was no recurrence of left inguinal hernia. The small necrotic bowel was resected and the femoral ring was repaired. The patient was discharged 8 days after the surgery, and there was no recurrence of femoral hernia after 1 year.

scholarly journals Small bowel perforation after low-velocity trauma: a case report

2021 ◽  
Vol 2021 (4) ◽  
Author(s):  
S Sinz ◽  
L Benigno ◽  
M A Zadnikar ◽  
M E Biraima-Steinemann
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Case Report ◽  
Small Bowel ◽  
Diagnostic Laparoscopy ◽  
Bowel Perforation ◽  
Small Bowel Perforation ◽  
Computed Tomography Scan ◽  
Low Velocity ◽  
Tomography Scan

Abstract We report the case of a 63-year-old patient with a low-velocity abdominal trauma and bowel perforation. The patient slipped on a wet floor and fell down the stairs. On admission, the patient complained about abdominal pain. A computed tomography scan showed traumatic hematoma of the jejunum in the left upper quadrant and a small amount of intra-abdominal air. Also rib fractures on the left side were diagnosed. We performed a diagnostic laparoscopy and found a bowel perforation, which was manually repaired.

scholarly journals Sclerosing Encapsulating Peritonitis

2014 ◽  
Vol 2 (1) ◽  
pp. 42-43
Author(s):  
Sharmistha Roy ◽  
Tapash Kumar Maitra ◽  
Samiron Kumar Mondal
Keyword(s):  
Small Bowel ◽  
Rare Condition ◽  
Young Girl ◽  
Abdominal Cocoon ◽  
Operative Finding ◽  
Sclerosing Encapsulating Peritonitis ◽  
Encapsulating Peritonitis

Sclerosing Encapsulating Peritonotis ( SEP) or Abdominal Cocoon is a rare condition characterized by total or partial encasement of the small bowel by a fibrocollagenous cocoon like sac. It was first described and named by Foo et al in 1978. Here we present a case of SEP or cocoon in a young girl with typical radiological and per operative finding. DOI: http://dx.doi.org/10.3329/bccj.v2i1.19969 Bangladesh Crit Care J March 2014; 2 (1): 42-43

scholarly journals Abdominal Cocoon or Encapsulating Peritoneal Sclerosis: A Rare Cause of Small Bowel Obstruction

2020 ◽  
Author(s):  
Omar Lasheen ◽  
Mohamed ElKorety
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Abdominal Cocoon ◽  
Accident And Emergency ◽  
History Of ◽  
Uncommon Condition ◽  
Accident And Emergency Department ◽  
Encapsulating Peritonitis ◽  
Contrast Ct

Encapsulating peritoneal sclerosis (EPS), also known as abdominal cocoon syndrome (AC) or sclerosing encapsulating peritonitis (SEP), is an uncommon condition typically presenting with features of bowel obstruction. We present the case of a 41-year-old male patient who presented to the accident and emergency department with a 7-day history of abdominal pain. Contrast CT of the abdomen and pelvis was ordered and was suggestive of small bowel obstruction involving most of the small bowel with no apparent transition point. Laparotomy showed a tough whitish fibrous membrane encasing the entire length of the small bowel. Advances in CT have made diagnosis possible before a decision on surgical intervention is made.

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