Another Look at the “Abdominal Cocoon”

Abstract

Abdominal cocoon is a rare cause of bowel obstruction. The condition was first described three decades ago and about 106 cases have so far been reported in the English literature. It is found mainly among adolescent females in tropical and sub-tropical countries. It is characterized by a thick fibrous membrane encapsulating the small intestines partially or completely. It should be differentiated from Encapsulating Peritoneal Sclerosis (EPS) and Peritoneal Encapsulation (PE) which are sometimes referred to as abdominal cocoon but are of different aetio-pathology. Patients present with features of intestinal obstruction and the diagnosis is usually made intraoperatively. Surgical excision of the membrane with adhesiolysis in an emergency exploratory laparotomy results in complete recovery. Appropriate management of this condition requires adequate knowledge about the disease. We present a review of this rare entity.

Key words: abdominal cocoon, intestinal obstruction