Dataset Information

Abdominal cocoon: A rare case report of a small bowel obstruction.

ABSTRACT:

Introduction

Sclerosing encapsulating peritonitis (SEP), or abdominal cocoon, is a remarkably rare entity. It consists of a fibrous layer or cocoon-like sac encasing, in most cases, the small bowel. The lack of specific symptoms makes preoperative diagnosis challenging.

Case presentation

A 50-year-old patient, with no history of abdominal surgery or medical diseases, was admitted for symptoms of small bowel obstruction. On examination, the patient was underweight with a BMI of 18 kg/m². Vital signs were stable. His abdomen was mildly distended and soft. Abdominal CT scan showed signs in favor of a left paraduodenal hernia with incarcerated small bowel loops. Intraoperatively, the small bowels were encapsulated in a cocoon-like structure formed by thick fibrous tissue associated with multiple adhesions. Careful adhesiolysis with complete resection of the membrane was performed. The postoperative course was uneventful. One year later, the patient was symptom-free.

Discussion

SEP is thought to be a persistent inflammatory disorder due to a cause that remains unidentified. It is divided into two categories based on its etiology: primary and secondary. The most common mode of SEP revelation is bowel obstruction. Because there is no clear consensus on SEP management, the therapeutic approach typically follows the management strategy of bowel obstruction.

Conclusion

SEP is an uncommon cause of bowel obstruction. Preoperative detection can be challenging in the absence of pathognomonic signs. Treatment is based on surgery, specifically entailing complete excision of the cocoon and adhesiolysis.

SUBMITTER: Hasnaoui A

PROVIDER: S-EPMC10551648 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Publications

Abdominal cocoon: A rare case report of a small bowel obstruction.

Hasnaoui Anis A Trigui Racem R Heni Sihem S Ramdass Prakash V A K PVAK

International journal of surgery case reports 20231002

<h4>Introduction</h4>Sclerosing encapsulating peritonitis (SEP), or abdominal cocoon, is a remarkably rare entity. It consists of a fibrous layer or cocoon-like sac encasing, in most cases, the small bowel. The lack of specific symptoms makes preoperative diagnosis challenging.<h4>Case presentation</h4>A 50-year-old patient, with no history of abdominal surgery or medical diseases, was admitted for symptoms of small bowel obstruction. On examination, the patient was underweight with a BMI of 18 ...[more]

PMID: 37793231

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Project description:BackgroundAscariasis, caused by the parasitic nematode Ascaris lumbricoides, is estimated to affect just under 900 million people globally, the majority of whom are children. Infections are most common in impoverished regions with poor water, sanitation, and hygiene, as transmission is reliant upon the ingestion of eggs excreted in feces found in contaminated soil.Case presentationAn 8-year-old Black African boy from the Sidama region, southern Ethiopia, presented at Adare General Hospital with a 3-day history of vomiting, abdominal pain, distension, and inability to pass stool or gas. Ultrasound confirmed a small bowel obstruction caused by a bolus of A. lumbricoides, which was successfully removed by surgical intervention via laparotomy and enterotomy. Postoperative treatment included the administration of anthelmintics and antibiotics, which led to stable recovery, with normal bowel function observed 1 month after surgery. The child's socioeconomic status, environmental conditions, and lack of knowledge about ascariasis transmission likely contributed to this severe infection, leading to the occurrence of the small bowel obstruction. Critically, his family lacked sanitation facilities, practiced open defecation, and consumed untreated surface water. The family did not participate in recent mass drug administration campaigns and had poor awareness of hygiene practices, highlighting gaps in the current national neglected tropical disease control program and deficiencies in public health education.ConclusionDespite Ethiopia's national deworming program being in existence since 2015, the lack of adequate water, sanitation, and hygiene infrastructure and awareness of risk-reducing behaviors, including participation in mass drug administration campaigns, has culminated in the continuation of A. lumbricoides transmission in many communities in Ethiopia. Enhanced mass drug administration coverage and robust water, sanitation, and hygiene interventions are the major goals of efforts in Ethiopia to reduce the national worm burden and prevent occurrence of severe complications such as small bowel obstruction caused by significant build-up of worms. As the presented case highlights, continuous community health education is essential for long-term control, as it increases mass drug administration participation and emphasizes the importance of good hygiene practices within communities. Fine-scale parasitological mapping and regular epidemiological assessments are necessary to identify high-risk families and communities and implement necessary treatment strategies.

Dataset Information

Abdominal cocoon: A rare case report of a small bowel obstruction.

Introduction

Case presentation

Discussion

Conclusion

Publications

Abdominal cocoon: A rare case report of a small bowel obstruction.

Similar Datasets

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