Abdominal Cocoon - An Interesting Case of Intestinal Obstruction

Introduction- Abdominal cocoon syndrome is characterized by small bowel encapsulation by a fibro-collagenous membrane forming a cocoon. It is a rare cause of intestinal obstruction. Presentation- A 18 year old female with no prior surgical history presented with acute onset pain in abdomen at night, with a palpable lump in right iliac fossa and hypogastric quadrants, after initial investigations exploratory laparotomy revealed terminal ileum in a fibrous encapsulated sac. The peritoneal sac was excised with adhesinolysis. The patient responded well to the treatment. Discussion- Most patients with abdominal cocoon syndrome present as a case of intestinal obstruction. Abdominal cocoon is a rare cause of the intestinal obstruction though the cause for cocoon formation is not evident in most cases. Conclusion- Abdominal cocoon is a rare cause of intestinal obstruction and proper diagnosis requires high index of suspicion. Peritoneal sac excision and adhesiolysis is treatment of choice.