abdominal cocoon radiology

Although described by various names in the In most of cases preoperative diagnosis is not made with certainty despite of advancement in imaging. Because of its peculiar characteristics, this condition presents many difficulties in preoperative diagnosis. of abdominal cocoon as a concentration of the whole small bowel to the center of the abdomen encased by a soft tissue-density mantle, mimicking a cocoon. The diagnosis is usually made during laparotomy. Abdominal cocoon syndrome, also known as Sclerosing Encapsulating Peritonitis, is characterized by a fibro-collagenous membrane that involves abdominal viscera and it's a rare cause of intestinal obstruction. Abdominal cocoon sonographic features: a case report. CT is the imaging modality of choice and allows identification of the thickened contrast material-enhanced abnormal peritoneal membrane and the encapsulated clumped bowel loops. The cause and pathogenesis of the condition have not been elucidated. It most commonly presents as nonspecific vague chronic abdominal pain and weight loss, and is difficult to recognize clinically until the patient develops symptoms of bowel obstruction. The possibility of abdominal cocoon should also be considered in infertile patients. So, most of cases are diagnosed at laparotomy. It is a relatively rare cause of intestinal obstruction and is found predominantly in adolescent girls. Encapsulating peritoneal sclerosis (EPS), also known as abdominal cocoon syndrome (AC) or sclerosing encapsulating peritonitis (SEP), is an uncommon condition typically presenting with features of bowel obstruction. Radiographic Findings. Encapsulating peritoneal sclerosis (EPS) is a rare but serious condition that results in (a) encapsulation of bowel within a thickened fibrocollagenous peritoneal membrane and (b) recurrent episodes of bowel obstruction. Abdominal cocoon syndrome is an acquired condition caused by an inflammatory process that is not yet completely understood. Abdominal cocoon is a relatively rare cause of intestinal obstruction. Less than 300 cases have been reported from all over the world. It is characterized by congenital development of an accessory peritoneal layer partially or entirely encapsulating the small bowel. This case shows cluster of collected small bowel loops in a strange way in the lower and upper abdomen, no history of renal disease or peritoneal dialysis and no past surgery and preoperatively diagnosed as internal hernia. Abdominal cocoon, or idiopathic sclerosing encapsulating peritonitis, is a rare condition of unknown cause characterized by total or partial encasement of the small bowel by a fibrocollagenous cocoon-like sac. References [1] Foo, K.T., Ng, K.C., Rauff ,A ., Foong ,W .C. The imaging features are, however, not pathognomonic. Preoperative diagnosis is rare. Acta Gastroenterol Belg. The authors describe a case wherein an organism was identified for the first time. Congenital peritoneal encapsulation is an extremely rare condition with an etiology based on abnormal embryonic gastrointestinal development. References 1 article features images from this case 17 public playlist include this case Promoted articles (advertising) Methods: Six cases of abdominal cocoon proved by surgery and pathologic findings were retrospectively analyzed. Patient concerns: The patient reported in this case was a 47-year-old man who suffered from abdominal pain and distension for 3 days. Abdominal cocoon is a rare acquired condition in which there is encapsulation of the small bowel by a fibrous membrane. Abdominal cocoon is a rare disorder that may pose a diagnostic conundrum in patients presenting with intermittent symptoms of small bowel obstruction. Abdominal cocoon or sclerosing encapsulating peritonitis (SEP) is a rare cause of intestinal obstruction described mostly in young adolescent girls. Journal of Ultrasound in Med 2003 July; 22(7): 719-21 Get full text Find similar topics on :: Scholar:: Radiology search engine 9. American Journal of Roentgenology 182: 639-641. Journal of Ultrasound in Med 2003 July; 22(7): 719-21 Get full text Find similar topics on :: Scholar:: Radiology search engine 9. We describe the imaging findings of a unique case of abdominal cocoon that presented in infancy. CECT of the abdomen is a useful radiological tool to aid in preoperative diagnosis. In most cases, the diagnosis is established during surgery. J ovani M, Baticci F, Bonifacio C, et al. In this case series, we aimed to present seven patients diagnosed with abdominal cocoon syndrome during operation. Excision of membrane is the definitive treatment of abdominal cocoon. Imaging studies may be helpful to make the correct diagnosis, and surgery should be performed for patients with recurrent acute or chronic intestinal obstruction. and Sinniah, R. (1978) Unusual Small Intestinal Obstruction in Adoles-cent Girls: The Abdominal . Evidence of ascites: > 500 mL required for plain film diagnosis. 193 cases have been described worldwide. The gastrointestinal barium meal series were undergone in 4 cases. There are many theories for the pathophysiology of the disease. MRI findings in intestinal cocoon. The operative findings were that the thick fibrous membrane was enclosing many loops of small bowel and . The involvement of the gastrointestinal (GI) system was a common feature during the second wave of COVID-19, and at present, there are reports of GI symptoms in patients who have completely recovered from COVID-19. The condition is poorly understood and often discovered incidentally, either intra-operatively or during autopsy. - Pelvic "dog's ear . - Lateral edge of liver displaced medially (Hellmer sign): Visible in 80% of patients with significant ascites. 2010;35:92-4. Diagnosis: X-ray, computed tomography, and magnetic resonance imaging revealed multiple peritoneal loose body and small bowel obstruction, characterized by a total . Lessons: Abdominal cocoon can occur at any age. W ang Q, Wang D. Abdominal cocoon: multi-detector row CT with multiplanar reformation and review of literatures. Br J Surg 65: 427- 430. Management of abdominal cocoon is controversial. American Journal of Radiology 2006 Mar; 186(3): 905-6 Get full . - Flank bulging. In addition, CT can potentially help identify the cause of EPS (omental granuloma in tuberculosis), as well as the complications of EPS (bowel obstruction). Peritoneal sac excision and adhesiolysis is the treatment and the outcome is usually satisfactory. This coil-ing of the small bowel in a concertina-like fashion has 928 M. Térébus Loock et al. Pandya JS, et al., OMICS J Radiol 2015, 4:2 DOI: 10.4172/2167-7964.1000183 Menassa-Moussa L, Bleibel L, Sader-Ghorra C, Smayra T, Aoun NJ. According to the clinical features, they were divided into three groups (asymptomatic . Identification of rare causes of bowel obstruction like internal hernia, abdominal cocoon and volvulus. Abdominal cocoon: preoperative diagnostic clues from radiologic imaging with pathologic correlation AJR Am J Roentgenol. MATERIALS AND METHODS: Clinical features and CT signs of 90 patients on PD were retrospectively reviewed. Sieck et al. Laparotomy and sac release were performed on the patient. Hur J, Kim KW, Park MS, Yu JS (2004) Abdominal Cocoon: Preoperative Diagnostic Clues from Radiologic Imaging with Pathologic Correlation. It is a highly uncommon cause of intestinal obstruction with limited case reports available in the medical literature especially pertaining to its imaging findings. Abdominal cocoon sonographic features: a case report. Two male patients, 29 and 75 years old, were admitted to our emergency department with abdominal pain, vomiting, tender and painful abdomen but without . We reported an unusual case of idiopathic cocoon abdomen with congenital colon malrotation. CT showed conglomerated intestinal loops showing mild dilatation at the center of the abdomen which is encased . / Clinical Radiology 65 (2010) 924e929 Table 3 treatment is required.28 At surgery, in addition to careful Computed tomography (CT) findings with respect to the presence of an dissection and excision of the covering membrane, dense abdominal cocoon (AC). MRI findings in intestinal cocoon. Abdominal cocoon is one of the rare causes of intestinal obstruction mostly diagnosed at the operating table. It is characterized by a thick fibrotic peritoneum that wraps the bowel in a concertinalike fashion with some adhesions. The exact cause is not known, it is most commonly associated with continuous ambulatory peritoneal dialysis [CAPD] and tuberculosis. Sclerosing encapsulating peritonitis, or abdominal cocoon, is a relatively rare cause of intestinal obstruction, described mostly in young adolescent girls. Abdominal cocoon: preoperative diagnostic clues from radiologic imaging with pathologic correlation. 7 Similar CT findings have been reported in some cases of paraduodenal hernias. Although described by various names in the literature, the preferred term is encapsulating peritoneal sclerosis because it best describes the morphologic and histologic . "Idiopathic sclerosing encapsulating peritonitis (or abdominal cocoon): a report of 5 cases" . American Surgeon , 83 (8), E297-E299. Authors Jin Hur 1 . The first description of abdominal cocoon was given by Owtschinnikow in 1907 who termed it as ''peritonitis chronica fibrosa incapsulata". Case Discussion. "Abdominal cocoon with imaging findings: Importance of radiology" . Its etiology is primarily unknown but can be secondary to known causes. Dig Liver Dis. Pre-operative clinical diagnosis is usually difficult. Idiopathic sclerosing encapsulating peritonitis (or abdominal cocoon) is a rare cause of small bowel obstruction, especially in adult population. 2014;46:192-3. Abdominal cocoon with bilateral cryptorchidism and seminoma in the right testis: a case report and review of literature Bingqing Yue1†, Zilian Cui1,2*†, Weiting Kang1, Hanbo Wang1, Yuzhu Xiang1, Zhilong Huang1 and Xunbo Jin1* Abstract Background: Abdominal cocoon is a rare peritoneal lesion and is difficult to diagnose because of its lack . Trauma-associated abdominal cocoon : Demonstration of radiographic evolution. Abdominal Radiology, Pictorial Essay . Cocoon sign: Sclerosing encapsulating peritonitis. Rationale: Abdominal cocoon and peritoneal loose body are both rare abdominal diseases. Search for more papers by this author. This occurs when the intestinal annulus is enveloped in the peritoneal cavity, resulting in intestinal obstruction. Diagnosis is usually incidental at laparotomy. 3. Its preoperative diagnosis and treatment strategy remains a challenge. The abdominal cocoon syndrome (or idiopathic encapsulating peritonitis) is a rare cause of intestinal obstruction. 2015 Jul-Sep 78(3):346-7. 2004 Mar;182(3):639-41. doi: 10.2214/ajr.182.3.1820639. Assessment of associated complications and differentiation of benign from malignant causes of intestinal obstruction. It is characterized by a thick fibrotic membrane that encases the bowel, forming a sac or cocoon along with some internal adhesions. The cause and pathogenesis of the condition have not been elucidated. Menassa-Moussa L, Bleibel L, Sader-Ghorra C, Smayra T, Aoun NJ. the imaging features of intestinal obstruction and perforation. It has been reported predominantly in adolescent girls living in tropical/subtropical region in which diagnosis is only made at laparotomy in most cases. We present a case of abdominal cocoon syndrome in a 65-year-old female and describe its clinical, imaging, and pathologic features. The author reports a case of a male patient with intermittent subacute intestinal obstruction and an abdominal cocoon encasing the small bowel secondary to abdominal tuberculosis, which was suspected preoperatively by radiology. We discuss one such rare case, outlining the fact that an . The clinical, pathological and radiological features of this unusual disease are reviewed. Abdominal cocoon is a rare disease with unknown etiology. Abdominal cocoon is a rare disease characterized by a thick brous membrane surrounding and compressing the small intes tines completely or partially, which results in mechanical small bowel. It is an uncommon cause of intestinal obstruction. Journal of the Belgian Society of Radiology is a peer-reviewed open access journal published by Ubiquity Press. The preoperative diagnosis of abdominal cocoon is difficult because of its nonspecific imaging findings, and reports are few in the literature on its radiologic imaging findings. Abdominal radiographic appearances are nonspecific and may be normal or may show: gas-fluid levels similar to those in patients with any other cause of small-bowel obstruction the wall of the "cocoon" may calcify Ultrasound clumped bowel loops trilaminar appearance of a hyperechoic membrane, hypoechoic bowel wall and hyperechoic bowel contents Abdominal CT examination revealed a small amount of free gas in the . Due to nonspecific clinical presentation and radiological findings, most cases are diagnosed incidentally at laparotomy, as in this case series. . in 1978 [ 1 ]. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Peritonitis [ 6] reported that a "cauliflower sign" on a contrast study of the small intestine is diagnostic. Internal hernia, intestinal volvulus, gallstone ileus, and bezoars are less-common possibilities, as is sclerosing encapsulated peritonitis, also called the abdominal cocoon syndrome. Thick fibrotic peritoneum encasing the small bowel is a pathognomonic feature. Abdominal cocoon is a synonym for sclerosing encapsulating peritonitis. [35-37] Cocoon abdomen refers to closely clustered bowel loops adherent within thickened peritoneum in a sac-like manner . Google Scholar; 4. Abdominal cocoon: uncommon cause of intestinal obstruction in peritoneal dialysis patient P I C T O R I A L M E D I C I N E A 47-year-old woman presented with abdominal pain and no bowel opening for 2 days in March 2011. World J Gastroenterol. SPECIAL ARTICLE Cocoon sign: Sclerosing encapsulating peritonitis Hao Xiang,1 Jason Han,1 William E Ridley2 and Lloyd J Ridley1,3 1Department of Radiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia 2University of New England, Armidale, New South Wales, Australia 3Medical Imaging, University of Sydney, Sydney, New South Wales, Australia Abdominal cocoon or sclerosing encapsulating peritonitis is a rare condition of bowel encapsulation by fibro-collagenous peritoneal membrane, leading to recurrent bowel obstruction. This entity was first reported by Foo et al. Abdominal cocoon or idiopathic encapsulating peritoneal sclerosis: magnetic resonance imaging. Abdominal cocoon is a rare cause of intestinal obstruction usually diagnosed incidentally at laparotomy. Abdominal cocoon syndrome (ACS), also known as idiopathic sclerosing peritonitis and primary sclerosing peritonitis, is a rare condition causing small bowel obstruction first described in 1978 by Foo et al . Trauma-associated abdominal cocoon: Demonstration of radiographic evolution. Pediatric Radiology - Springer Journals. Abdominal cocoon, or sclerosing encapsulating peritonitis, is a rare cause of intestinal obstruction which usually remains undiagnosed pre-operatively. Abdominal cocoon is a rare condition causing intestinal obstruction and diagnosis requires a high index of suspicion because of the nonspecific clinical picture. We present the case of a 41-year-old male patient who presented to the accident and emergency department with a 7-day history of abdominal pain. 3. Imaging plays a critical role in timely and accurate diagnosis. Jason Han, Department of Radiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia. References 20 public playlist include this case Abdominal cocoon or idiopathic encapsulating peritoneal sclerosis: Magnetic resonance imaging Manol Jovani, Fabio Baticci, Cristiana Bonifacio, Paolo Dario Omodei, Alberto Malesci Istituto Clinico Humanitas Prolonged administration of practalol, meconium . The abdominal cocoon or 'sclerosing encapsulating peritonitis' (SEP) is a rare condition which is characterized by a fibrocollagenic cocoon-like sac enveloping the small bowel. References 20 public playlist include this case Published: Jun 29, 2011 A high index of suspicion is required in diagnosing abdominal cocoon. Abdominal Radiology, Original Research . We present a brief discussion on this topic with relevant imag … Abdominal cocoon is characterized by the total or partial wrapping of the abdominal organs by a fibrous membrane. The aim of this study is to present two cases of ACS successfully treated at the Surgical Clinic of the Agios Dimitrios . The imaging findings were analyzed. Peritoneal encapsulation, a related subject, is also discussed. Cocoon abdomen is a relatively rare abdominal disease characterized by the total or partial encasement of the small intestinal by a dense fibro-collagenous membrane. Discussion: Abdominal cocoon is a rare entity, and its etiology is poorly understood. . Sclerosing encapsulated peritonitis (SEP) is a rare chronic peritoneal inflammation with unknown etiology, and is also known as abdominal cocoon. We describe the imaging findings of a unique case of abdominal cocoon that presented in infancy. • Radiography. Abdom Imaging. 2007 Jul 14 13(26):3649-51. To the best of our knowledge, this case represents one of the very few male patients with this disease entity . The Abdominal Cocoon Encapsulating peritoneal sclerosis (EPS) is a rare but serious condi-tion that results in (a) encapsulation of bowel within a thickened fibrocollagenous peritoneal membrane and (b) recurrent episodes of bowel obstruction. Whole of small gut seen as a cocoon Abdominal cocoon is a rare disease, characterized by a thick fibrotic membrane that wraps the small bowel in a concertina-like fashion. Abdominal cocoon (also known as sclerosing encapsulating peritonitis) is rare and represents fibrosing peritonitis with resulting in encasement of the small bowel. Having been on continuous ambulatory peritoneal dialysis (CAPD) for 10 years, she had Abdominal cocoon syndrome is a rare condition characterized by small bowel encapsulation by a fibrous membrane or a cocoon-like sac. It is characterised by total or partial encasement of the small bowel in a fibrocollagenous cocoon-like sac accompanied by extensive intrinsic small bowel adhesions. Dr Sumer Sethi is Leading Medical Edupreneur, Radiologist and Innovator, Speaks about medical education, radiology & digital innovationsThank You for watchin. Idiopathic sclerosing encapsulating peritonitis or abdominal cocoon syndrome (ACS) is a rare anatomical deformity characterized by the partial or complete encasement of the small intestine with fibrotic peritoneum. Abdominal Cocoon: A descriptive term for the fibrotic encasement of the entire small intestine in sclerosing peritonitis, a spontaneous idiopathic process in young women, which follows peritoneovenous shunting, practolol therapy, peritoneal dialysis, chemotherapy, or in which other unknown toxins stimulate fibroblastic proliferation and . With pathologic correlation AJR Am J Roentgenol diagnosis is only made at laparotomy can be secondary to known causes describe... 5 cases & quot ; cauliflower sign & quot ; pathogenesis of abdomen!, subclinical viral peritonitis, and laparotomy, as in this case report viral,... 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