A Rare Case Report of Idiopathic Abdominal Cocoon Presenting as Acute Intestinal Obstruction-Management Challenges

Pawan Sharma, V. Nair, Simarjit Singh Rehsi, Vivek Kumar Singh
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Abstract

The idiopathic variant of sclerosing Intraperitoneal fibrosis is a rare pathological entity causing intestinal obstruction. Even though it is described since the beginning of the last century, we are still clueless about the aetiology of this problem. The presentation is often confusing and the clinical and laboratory values will be not confirmatory to establish a diagnosis. A Contrast-enhanced CT scan is a vital investigation of choice. Here we discuss a case of intestinal obstruction with a preop diagnosis of internal herniation, which turned out to be a case of massive intraperitoneal fibrosis. The histopathology was not significant, and no secondary cause was identified. The case report throws wisdom into the existence of this entity and how with a CT scan we can suspect it before surgery. With adequate and meticulous enterolysis we can surgically rehabilitate these patients so that they can lead a normal life.
一例罕见的特发性腹部茧表现为急性肠梗阻管理挑战的病例报告
特发性硬化性腹膜内纤维化是一种罕见的引起肠梗阻的病理实体。尽管自上个世纪初就有人对其进行了描述,但我们仍然对这一问题的病因一无所知。表现往往令人困惑,临床和实验室值将不能确定建立诊断。对比增强CT扫描是一个重要的调查选择。我们在此讨论一例术前诊断为腹内疝的肠梗阻,结果发现是腹膜内大量纤维化。组织病理学无显著差异,未发现继发原因。该病例报告为这种实体的存在以及如何在手术前通过CT扫描来怀疑它提供了智慧。通过充分细致的肠溶,我们可以通过手术使这些病人恢复正常生活。
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