Open AccessRare etiology of mechanical intestinal obstruction: Abdominal cocoon syndrome
Author(s) -
Mustafa Yener Uzunoglu,
Fatih Altıntoprak,
Ömer Yalkın,
Yasemin Gündüz,
Güner Çakmak,
Orhan Veli Özkan,
Fehmi Çelebi
Publication year - 2014
Publication title -
world journal of clinical cases
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.368
H-Index - 10
ISSN - 2307-8960
DOI - 10.12998/wjcc.v2.i11.728
Subject(s) - medicine , etiology , abdomen , vomiting , abdominal pain , nausea , physical examination , surgery , acute abdomen , radiology , emergency department , quadrant (abdomen) , pathology , psychiatry
Abdominal cocoon syndrome is a rare cause of intestinal obstruction with unknown etiology. Diagnosis of this syndrome, which can be summarized as the small intestine being surrounded by a fibrous capsule not containing the mesothelium, is difficult in the preoperative period. A 47-year-old male patient was referred to the emergency department with complaints of abdominal pain, nausea, and vomiting for two days. The abdominal computed tomography examination detected dilated small intestinal loops containing air-fluid levels clustered in the left upper quadrant of the abdomen and surrounded by a thick, saclike, contrast-enhanced membrane. During exploratory surgery, a capsular structure was identified in the upper left quadrant with a regular surface that was solid-fibrous in nature. Abdominal cocoon syndrome is a rarely seen condition, for which the preoperative diagnosis is difficult. The combination of physical examination and radiological signs, and the knowledge of "recurrent characteristics of the complaints" that can be learned by a careful history, may be helpful in diagnosis.