Diagnosis and surgical management of abdominal cocoon: results from 12 cases

This study was designed to describe the characteristics, diagnostic and therapeutic methods of abdominal cocoon. Twelve patients with abdominal cocoon were treated with surgery. The clinical findings from these patients were analyzed. All patients presented with acute complete intestinal obstruction, and 10 had a previous history of abdominal mass. In nine patients, the whole or part of the small intestines were covered by an ash gray, dense and tough fibrous membrane. The capsule was surgically excised, and the adhesion was released. Partial resection of the small intestines was performed. In the other three patients, the small intestines were only partially covered by a membrane, and there was an extensive adhesion of intestinal tract, forming a large mass which could not be relieved by surgical lysis. Intestinal tube was put in, and fistulation procedures were performed. All patients recovered fully after the surgery. In conclusion, the common clinical presentations of abdominal cocoons are signs and symptoms of acute or chronic intestinal obstruction. Abdominal mass is also present in majority of the patients before the intestinal obstruction. Surgery is the main therapeutic option for these patients.