Xu R, Sun LX, Chen Y, Ding C, Zhang M, Chen TF, Kong LY. Stoma occlusion caused by abdominal cocoon after abdominal abscess surgery: A case report. World J Clin Cases 2025; 13(15): 98608 [DOI: 10.12998/wjcc.v13.i15.98608]
Corresponding Author of This Article
Ling-Yong Kong, Chief Doctor, Department of General Surgery, The People’s Hospital of Suqian City, No. 138 Huanghe South Road, Sucheng District, Suqian 223800, Jiangsu Province, China. 1871920880@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
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 Clin Cases. May 26, 2025; 13(15): 98608 Published online May 26, 2025. doi: 10.12998/wjcc.v13.i15.98608
Stoma occlusion caused by abdominal cocoon after abdominal abscess surgery: A case report
Rui Xu, Li-Xin Sun, Yan Chen, Chuang Ding, Ming Zhang, Teng-Fei Chen, Ling-Yong Kong
Rui Xu, Li-Xin Sun, Yan Chen, Chuang Ding, Ming Zhang, Teng-Fei Chen, Ling-Yong Kong, Department of General Surgery, The People’s Hospital of Suqian City, Suqian 223800, Jiangsu Province, China
Co-first authors: Rui Xu and Li-Xin Sun.
Co-corresponding authors: Yan Chen and Ling-Yong Kong.
Author contributions: Xu R and Sun LX contributed equally to this study as co-first authors; Chen Y and Kong LY contributed equally to this study as co-corresponding authors; Xu R, Sun LX, and Chen Y designed the study and drafted the manuscript; Ding C and Zhang M performed the surgery; Chen TF edited the paper; Kong LY provided academic advice.
Supported by Suqian Science and Technology Project Contract, No. S201910.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ling-Yong Kong, Chief Doctor, Department of General Surgery, The People’s Hospital of Suqian City, No. 138 Huanghe South Road, Sucheng District, Suqian 223800, Jiangsu Province, China. 1871920880@qq.com
Received: June 30, 2024 Revised: November 27, 2024 Accepted: January 2, 2025 Published online: May 26, 2025 Processing time: 204 Days and 14.7 Hours
Abstract
BACKGROUND
Abdominal cocoons (ACs) lack characteristic clinical manifestations and are mainly intestinal obstructions that are difficult to distinguish from intestinal obstruction caused by other causes, resulting in difficult preoperative diagnosis and misdiagnosis and mistreatment. There are no reports of enterostomy occlusion caused by ACs in the literature at home and abroad.
CASE SUMMARY
Here, we report a 16-year-old female patient with intestinal obstruction due to AC. She was treated with abdominal surgery three times. First, she underwent a laparotomy for peritonitis after trauma from a traffic accident. During the procedure, pelvic empyema, severe intestinal adhesions, and damage to the serous layer of the rectum were found, but no significant intestinal rupture and perforation were found. As a precaution, she underwent a prophylactic ileostomy after a flush in her abdomen. The second and third surgeries were for treatment of recurrent stoma obstruction. The patient’s condition was complicated for a long period, but after comprehensive treatment by our department, the patient was successfully discharged from the hospital and is currently recovering well.
CONCLUSION
Currently, abdominal contrast-enhanced computed tomography is the best imaging modality for preoperative evaluation of AC, but most patients are diagnosed only after intraoperative exploration. For the treatment of typical or severe ACs, the primary method of removal and healing of ACs is complete removal of the abdominal fibrous membrane. Finding a breakthrough in the anatomy is the key to the success of the surgery.
Core Tip: This work reported a case of ostomy occlusion due to abdominal cocoons after post-traumatic ileostomy. The patient underwent three consecutive abdominal surgeries and had a complex condition. In our hospital, she was treated scientifically and underwent two consecutive abdominal surgeries. In the end, she was successfully discharged from the hospital and is now recovering well. This rare case is important to summarize for the medical community. Combined with a literature review, the pathogenesis, clinical manifestations, and treatment strategies of abdominal cocoons were summarized.
