Keese D, Schmedding A, Saalabian K, Lakshin G, Fiegel H, Rolle U. Abdominal cocoon in children: A case report and review of literature. World J Gastroenterol 2021; 27(37): 6332-6344 [PMID: 34712036 DOI: 10.3748/wjg.v27.i37.6332]
Corresponding Author of This Article
Udo Rolle, FRCS (Hon), MD, MSc, Chairman, Dean, Director, Professor, Goethe-University Frankfurt, Department of Paediatric Surgery and Paediatric Urology, University Hospital, Theodor-Stern-Kai 7, Frankfurt 60590, Germany. udo.rolle@kgu.de
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Oct 7, 2021; 27(37): 6332-6344 Published online Oct 7, 2021. doi: 10.3748/wjg.v27.i37.6332
Abdominal cocoon in children: A case report and review of literature
Daniel Keese, Andrea Schmedding, Kerstin Saalabian, Georgy Lakshin, Henning Fiegel, Udo Rolle
Daniel Keese, Andrea Schmedding, Kerstin Saalabian, Georgy Lakshin, Henning Fiegel, Udo Rolle, Goethe-University Frankfurt, Department of Paediatric Surgery and Paediatric Urology, University Hospital, Frankfurt 60590, Germany
Author contributions: Keese D, Schmedding A, Saalabian K, and Rolle U contributed to the study conception and design, acquisition, analysis, and interpretation of the data, and final approval of the version of the article to be published; Keese D drafted the article; Lakshin G, Fiegel H, and Rolle U contributed to critical revisions related to the intellectual content of the manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrolment.
Conflict-of-interest statement: None of the authors has a conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Udo Rolle, FRCS (Hon), MD, MSc, Chairman, Dean, Director, Professor, Goethe-University Frankfurt, Department of Paediatric Surgery and Paediatric Urology, University Hospital, Theodor-Stern-Kai 7, Frankfurt 60590, Germany. udo.rolle@kgu.de
Received: February 18, 2021 Peer-review started: February 18, 2021 First decision: April 18, 2021 Revised: April 30, 2021 Accepted: August 20, 2021 Article in press: August 20, 2021 Published online: October 7, 2021 Processing time: 222 Days and 17.2 Hours
Abstract
BACKGROUND
Abdominal cocoon or “encapsulating peritoneal sclerosis” (EPS) is an uncommon and rare cause of intestinal obstruction. Only a few cases have been reported in paediatric patients. Typically, EPS is described as the primary form in young adolescent girls from tropical and subtropical countries because of viral peritonitis due to retrograde menstruation or a history of peritoneal dialysis. Most patients are asymptomatic or present with abdominal pain, which is likely to occur secondary to subacute bowel obstruction. Findings at imaging, such as ultrasound, computed tomography, and magnetic resonance imaging, are often nonspecific. When diagnosed, EPS is characterized by total or partial encasement of the bowel within a thick fibrocollagenous membrane that envelopes the small intestine in the form of a cocoon because of chronic intraabdominal fibroinflammatory processes. The membrane forms a fibrous tissue sheet that covers, fixes, and finely constricts the gut, compromising its motility.
CASE SUMMARY
We present a case of EPS in a 12-year-old boy 8 wk after primary surgery for resection of symptomatic jejunal angiodysplasia. There was no history of peritoneal dialysis or drug intake.
CONCLUSION
In this report, we sought to highlight the diagnostic, surgical, and histopathological characteristics and review the current literature on EPS in paediatric patients.
Core Tip: Abdominal cocoon syndrome is rare in children. Cases with no history of previous peritoneal dialysis are practically nonexistent. Our report of a 12-year-old boy reveals that abdominal surgery can be a trigger for the development of encapsulating peritoneal sclerosis (EPS). Indications for surgery for EPS are usually due to mechanical ileus, and the final diagnosis is made intraoperatively. Surgical therapy for EPS is the first choice, and total intestinal enterolysis of EPS seems to be the best approach. The long-term prognosis for children is good.
