Regarding abdominal cocoon all statements are true except:: (A) Common in Young girl, (B) Associated with liver fibrosis, (C) Fibrosis of small bowel and stomach, (D) Chronic peritonitis is seen
Answer is B. Idiopathic Sclerosing Encapsulating peritonitis(Abdominal Cocoon) It is a rare condition of unknown cause in which intestinal obstruction results from the encasement of variable lengths of bowel by a dense fibrocollagenous membrane that gives the appearance of a cocoon Causes of Cocoon Previous abdominal surgery or peritonitis Chronic ambulatory peritoneal dialysis (CAPD) Prolonged use of beta-blocker propanalol Use of povidone iodine for abdominal wash out Placement of Lee Veen shunt for refractory ascites SLE Clinical Features: Occurence of intestinal obstruction in a relatively young girl without an obvious cause History of similar episodes that resolved spontaneously Abdominal pain and vomiting Presence of a non tender soft mass on abdominal palpation Features of increasing abdominal distension, jaundice and features suggestive of Liver Pathology Diagnosis: Barium meal follow through : Serpentine configuration of small bowel CT scan is helpful Treatment: Laparotomy with removal of the membrane, after which recovery is usually complete Ref: www.emedicine_hlml/cocoon