Abdominal cocoon syndrome-a rare culprit behind small bowel ischemia and obstruction: Three case reports

Figure 1 Physical exam of bulging mid-abdomen. A: Lateral view of abdomen; B: Bird eye view of abdomen.

Figure 2 Abdominal X-ray and computed tomography scan whole abdomen with contrast. A: Upright view; B: Supine view; C and D: Computed tomography scan of enhancing peritoneum (cocoon-like) without small bowel dilatation.

Figure 3 Abdominal X-rays. A: Gasless small bowel from X-ray in 1^st visit; B: Small bowel devoid of gas observed on the fifth day after the completion of a colonoscopy procedure; C: Disappearance of gasless small bowel after operation.

Figure 4 Computed tomography scan whole abdomen with contrast. A and B: Stacking small bowel loops inside a thick membrane-like sac; C: Small bowel feces sign (asterisk); D: Normal alignment of the small bowel after operation.

Figure 5 Abdominal X-ray and computed tomography whole abdomen with oral and IV contrast. A: Gasless small bowel; B and C: Stacking small bowel loops inside a thick membrane-like sac.

Figure 6 Intraoperative finding of encapsulated of intestine. A: Entire intestine with dense fibrous tissue; B: Partial resection of dense fibrous tissue; C: After complete resection of all fibrous tissue with small bowel necrosis.

Figure 7 Intraoperative images. A: Fibrous sheath encapsulated small bowel; B: Small bowel after complete adhesiolysis.

Figure 8  Intraoperative finding.