Volume 8, Issue 3 (In Press 2020)                   J. Pediatr. Rev 2020, 8(3): 0-0 | Back to browse issues page

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Mahajan N, Agarwal M, Khatri A, Siddiqui Y M B, Sengar M. Abdominal cocoon syndrome: A rarely thought of differential in children presenting with intestinal obstruction: A Case Report and review of literature. J. Pediatr. Rev. 2020; 8 (3)
URL: http://jpr.mazums.ac.ir/article-1-310-en.html
1- Chacha Nehru Bal Chikitsalya, Geeta Colony, Delhi-110031, India
2- Chacha Nehru Bal Chikitsalya, Geeta Colony, Delhi-110031, India , a.khatri2008@gmail.com
Abstract:   (217 Views)
Introduction: Abdominal cocoon syndrome or idiopathic sclerosing encapsulating peritonitis(SEP) is an extremely uncommon cause of intestinal obstruction. The etiology is debatable with many theories.
Case Presentation: An eleven-year-old girl presented to Pediatric Surgery OPD in  with complaints of abdominal pain for past two weeks and vomiting for two days. Family history for Tuberculosis was positive. On examination, the abdomen was distended and slightly firm on palpation. X Ray of abdomen showed multiple air fluid levels. CECT abdomen showed dilated stomach, duodenum and proximal bowel loops. Some trapped inter bowel free fluid was also seen. In view of the clinical presentation of subacute intestinal obstruction and the radiological features, a differential diagnosis of tubercular peritonitis versus pseudomyxoma peritonei was suggested. In view of obstructive symptoms, the patient  was taken up for explorative laparotomy. Per operatively, a thin membranous sac was identified enclosing multiple dilated small bowel loops The sac was released by blunt dissection and part of the sac was sent for histopathological examination. Based on clinical, histopathological and radiological findings, a diagnosis of Abdominal cocoon syndrome was given. The postoperative follow -up period of six months was uneventful.
Conclusion: We present here the rare case of primary sclerosing encapsulating peritonitis, also reported as abdominal cocoon syndrome. It is one of the rare potentially devastating cause of intestinal obstruction in children. A very high index of suspicion is imperative to arrive to its  pre-operative diagnosis alone by clinical and radiological findings.
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Type of Study: Case Report and Review of Literature | Subject: Pediatric Gastroenterology
Received: 2020/02/12 | Accepted: 2020/04/18 | Published: 2020/04/21

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