Editorial
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. May 7, 2012; 18(17): 1999-2004
Published online May 7, 2012. doi: 10.3748/wjg.v18.i17.1999
Idiopathic sclerosing encapsulating peritonitis: Abdominal cocoon
Jenny N Tannoury, Bassam N Abboud
Jenny N Tannoury, Bassam N Abboud, Department of General Surgery, Faculty of Medicine, Hotel Dieu de France Hospital, Saint-Joseph University, Beirut 16-6830, Lebanon
Author contributions: Abboud BN designed the research; Tannoury JN and Abboud BN performed the research; Tannoury JN and Abboud BN analyzed the data; Tannoury JN and Abboud BN wrote the paper.
Correspondence to: Bassam N Abboud, MD, Professor, Department of General Surgery, Faculty of Medicine, Hotel Dieu de France Hospital, Saint-Joseph University, Alfred Naccache Street, Beirut 16-6830, Lebanon. dbabboud@yahoo.fr
Telephone: +961-1-615300  Fax: +961-1-615295
Received: November 21, 2011
Revised: February 20, 2012
Accepted: February 26, 2012
Published online: May 7, 2012
Abstract

Abdominal cocoon, the idiopathic form of sclerosing encapsulating peritonitis, is a rare condition of unknown etiology that results in an intestinal obstruction due to total or partial encapsulation of the small bowel by a fibrocollagenous membrane. Preoperative diagnosis requires a high index of clinical suspicion. The early clinical features are nonspecific, are often not recognized and it is difficult to make a definite pre-operative diagnosis. Clinical suspicion may be generated by the recurrent episodes of small intestinal obstruction combined with relevant imaging findings and lack of other plausible etiologies. The radiological diagnosis of abdominal cocoon may now be confidently made on computed tomography scan. Surgery is important in the management of this disease. Careful dissection and excision of the thick sac with the release of the small intestine leads to complete recovery in the vast majority of cases.

Keywords: Peritonitis; Sclerosis; Encapsulate; Intestinal obstruction; Computed tomography scan; Surgery