Case Report
Copyright ©2007 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2007; 13(26): 3649-3651
Published online Jul 14, 2007. doi: 10.3748/wjg.v13.i26.3649
Idiopathic sclerosing encapsulating peritonitis (or abdominal cocoon): A report of 5 cases
Ping Xu, Li-Hua Chen, You-Ming Li
Ping Xu, Li-Hua Chen, You-Ming Li, Department of Gastroenterology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Li You-Ming, Department of Gastroenterology, First Affiliated Hospital, Zhejiang University School of Medicine, Qingchun Road 79, Hangzhou 310003, Zhejiang Province, China. zlym@zju.edu.cn
Telephone: +86-571-87236603
Received: March 15, 2007
Revised: March 18, 2007
Accepted: April 7, 2007
Published online: July 14, 2007
Abstract

Sclerosing encapsulating peritonitis (SEP) is a rare cause of intestinal obstruction that is characterized by a thick grayish-white fibrotic membrane encasing the small bowel. SEP can be classified as idiopathic, also known as abdominal cocoon, or secondary. It is difficult to make a definite pre-operative diagnosis. We experienced five cases of abdominal cocoon, and the case files were reviewed retrospectively for the clinical presentation, operative findings and outcome. All the patients presented with acute, subacute and chronic intestinal obstruction. Computed tomography (CT) showed characteristic findings of small bowel loops congregated to the center of the abdomen encased by a soft-tissue density mantle in four cases. Four cases had an uneventful post-operative period, one case received second adhesiolysis due to persistent ileus. The imaging techniques may facilitate pre-operative diagnosis. Surgery is important in the management of SEP.

Keywords: Sclerosing encapsulating peritonitis, Idiopathic, Abdominal cocoon, Intestinal obstruction, Adhesiolysis