Abdominal Cocoon Syndrome: A Case Report

Abdominal cocoon syndrome, intestinal obstruction, sclerosing encapsulating peritonitis.

Authors

  • Meher Angez Rahman Radiologist, Department of Radiology and Imaging. Suri Seri Begawan Hospital, Ministry of health, Brunei Darussalam
  • Mizanul Hasan Consultant, Ultrasound Department, Popular Diagnostic Centre Limited, Dhanmondi, Dhaka, Bangladesh
  • Nurfizah Nadiah Binti Hj Sulaiman Radiographer, Department of Radiology and Imaging. RIPAS Hospital, Ministry of health, Brunei Darussalam
Vol. 13 No. 06 (2025)
Medical Sciences and Pharmacy
June 18, 2025

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Abdominal cocoon syndrome (ACS) is defined as idiopathic partial or total encapsulation of the bowel and other abdominal organ within a fibrocollageneous membrane and considered as a rare cause of small bowel obstruction (1). Also known as primary sclerosing encapsulating peritonitis (SEP).  The presence of fibrous membranes that encompasses the intestines forming a sort of butterfly cocoon. Patients often present with symptoms of partial intestinal obstruction, which is challenging to diagnose before laparotomy. Of all the available investigations, the contrast-enhanced computed tomography of the abdomen is the most sensitive, showing a sac like fibrous membrane covering the bowel loops along with the fluid collection. Definitive treatment includes excision and adhesiolysis.