Abdominal Cocoon: Clinical Presentation, Diagnosis, and Management |
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Authors: | Debajyoti Mohanty Bhupendra Kumar Jain Juhi Agrawal Arun Gupta Vivek Agrawal |
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Institution: | (1) Department of Surgery, Guru Teg Bahadur Hospital, University College of Medical Sciences, Delhi, 110 095, India;(2) KE-92, Kavi Nagar, Ghaziabad, 201002, India |
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Abstract: | A 15-year-old girl presented with features suggestive of sub-acute intestinal obstruction (SAIO) with a palpable abdominal
lump. Contrast-enhanced computed tomogram (CECT) abdomen revealed congregated small gut loops confined to a single area and
encased in a thick membrane suggestive of abdominal cocoon. On laparotomy, a thick white membrane was found encasing most
of the small gut. The cocoon was excised releasing the encased small bowel. The patient was relieved of her symptoms following
surgery. Histopathology of excised cocoon membrane revealed granulomatous inflammation consistent with tuberculosis. The patient
was discharged on ninth postoperative day with advice to take anti-tuberculosis drugs for 6 months. The possibility of abdominal
cocoon should be considered in patients with SAIO and abdominal lump. Abdominal cocoon being a rare condition, CECT is useful
in clinching the diagnosis and planning elective surgery in experienced hands. |
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Keywords: | Abdominal cocoon Sclerosing encapsulating peritonitis Intestinal obstruction Low-grade peritonitis CECT abdomen |
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