Abdominal cocoon syndrome-a rare culprit behind small bowel ischemia and obstruction:Three case reports  

作　　者：Witcha Vipudhamorn Tawan Juthasilaparut Pawit Sutharat Suwan Sanmee Ekkarin Supatrakul 

机构地区：[1]Department of Colorectal Surgery,Chiang Mai University,Chiang Mai 50200,Thailand [2]Department of Surgery,Lampang Hospital,Lampang 52000,Thailand

出　　处：《World Journal of Gastrointestinal Surgery》2024年第3期955-965,共11页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND Abdominal cocoon syndrome(ACS)represents a category within sclerosing encapsulating peritonitis,characterized by the encapsulation of internal organs with a fibrous,cocoon-like membrane of unknown origin,resulting in bowel obstruction and ischemia.Diagnosing this condition before surgery poses a cha-llenge,often requiring confirmation during laparotomy.In this context,we depict three instances of ACS:One linked to intestinal obstruction,the second exclu-sively manifesting as intestinal ischemia without any obstruction,and the final case involving a discrepancy between the radiologist and the surgeon.CASE SUMMARY Three male patients,aged 53,58,and 61 originating from Northern Thailand,arrived at our medical facility complaining of abdominal pain without any prior surgeries.Their vital signs remained stable during the assessment.The diagnosis of abdominal cocoon was confirmed through abdominal computed tomography(CT)before surgery.In the first case,the CT scan revealed capsules around the small bowel loops,showing no enhancement,along with mesenteric congestion affecting both small and large bowel loops,without a clear obstruction.The second case showed intestinal obstruction due to an encapsulated capsule on the CT scan.In the final case,a patient presented with recurring abdominal pain.Initially,the radiologist suspected enteritis as the cause after the CT scan.However,a detailed review led the surgeon to suspect encapsulating peritoneal sclerosis(ACS)and subsequently perform surgery.The surgical procedure involved complete removal of the encapsulating structure,resection of a portion of the small bowel,and end-to-end anastomosis.No complications occurred during surgery,and the patients had a smooth recovery after surgery,eventually discharged in good health.The histopathological examination of the fibrous membrane(cocoon)across all cases consistently revealed the presence of fibro-collagenous tissue,without any indications of malignancy.CONCLUSION Individuals diagnosed with abdominal cocoons commonly

关 键 词：Sclerosing encapsulation peritonitis Abdominal cocoon Peritoneal Fibrosis Peritoneal encapsulation syndrome Intestinal obstruction Surgery Case report 

分 类 号：R656.7[医药卫生—外科学]