Abdominal Cocoon Causing Small Bowel Obstruction: Rarity

P; ya JS; Waghmare SB; Thakre MM

doi:10.4172/2167-7964.1000183

ISSN:2167-7964

Journal of Radiology

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Abdominal Cocoon Causing Small Bowel Obstruction: Rarity

*Pandya JS^, Waghmare SB and Thakre MM**
B.Y.L. Nair Hospital, Mumbai, Maharashtra, India
Corresponding Author :	Pandya JS B.Y.L. Nair Hospital, Mumbai Maharashtra, India- 400008 Tel: +02223027148 Fax: 022-28548499 E-mail: smruti63@hotmail.com
Received April 06, 2015; Accepted April 21, 2015; Published April 24, 2015
Citation: Pandya JS, Waghmare SB and Thakre MM (2015) Abdominal Cocoon Causing Small Bowel Obstruction: Rarity. OMICS J Radiol 4:183. doi:10.4172/2167-7964.1000183
Copyright: © 2015 Pandya JS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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A 42 year-old male presented with abdominal pain and multiple episodes of vomiting since last month. He had several such episodes in the past with spontaneous relief. The abdomen was doughy on palpation with lumpish feel in supraumbilical region. X-ray abdomen was normal. CECT abdomen revealed clumping of small bowel surrounded by thickened membrane (Figure 1). At laparotomy the entire small bowel was encased in a cocoon-like fibrous membrane (Figure 2). Extensive adhesiolysis and excision of membrane was done. Histopathology showed lymphocytic inflammation with few gaint cells with the final impression being sclerosing encapsulating peritonitis.

Abdominal cocoon syndrome (sclerosing peritonitis or sclerosing encapsulating peritonitis) is characterized by partial or complete encasement of small bowel by a thick ring of fibrous tissue, causing clustering of the bowel [1]. Foo et al. first applied the term “abdominal cocoon” in 1978 [2]. The etiopathogenesis is unclear. A history of previous abdominal surgery or peritonitis, chronic ambulatory peritoneal dialysis, and the prolonged use of practolol have been implicated as causative factors [3].