Abdominal cocoon Case contributed by Dr Adhikari Deepak Diagnosis almost certain Edit case Share Add to Citation, DOI and case data Presentation Abdominal pain with lump for 1 month Patient Data Gender: Female CT CT The small bowels are clumped together within the thin sac at central abdomen. Menassa-Moussa L, Bleibel L, Sader-Ghorra C, Smayra T, Aoun NJ. Less than 300 cases have been reported from all over the world. Imaging and treatment of idiopathic abdominal cocoon in 9 patients Buy Article: $42.00 + tax (Refund Policy) American Journal of Radiology 2006 Mar; 186(3): 905-6 Get full . 2014;46:192-3. [ 6] reported that a "cauliflower sign" on a contrast study of the small intestine is diagnostic. Idiopathic sclerosing encapsulating peritonitis (or abdominal cocoon) is a rare cause of small bowel obstruction, especially in adult population. Abdominal cocoon, or idiopathic sclerosing encapsulating peritonitis, is a rare condition of unknown cause characterized by total or partial encasement of the small bowel by a fibrocollagenous cocoon-like sac. To the best of our knowledge, this case represents one of the very few male patients with this disease entity . Pre-operative clinical diagnosis is usually difficult. Sclerosing encapsulating peritonitis or abdominal cocoon, as the name suggests, implies to encasement of the small bowel by a thick fibrous cocoon like sac. - Indistinct psoas margin. Abdominal cocoon sonographic features: a case report. Abdom Imaging. References 1 article features images from this case 17 public playlist include this case Promoted articles (advertising) Discussion: Abdominal cocoon is a rare entity, and its etiology is poorly understood. Abdominal cocoon is a rare disorder that may pose a diagnostic conundrum in patients presenting with intermittent symptoms of small bowel obstruction. Sclerosing encapsulating peritonitis, or abdominal cocoon, is a relatively rare cause of intestinal obstruction, described mostly in young adolescent girls. References 20 public playlist include this case The cause and pathogenesis of the condition have not been elucidated. American Journal of Roentgenology 182: 639-641. The preoperative diagnosis of abdominal cocoon is difficult because of its nonspecific imaging findings, and reports are few in the literature on its radiologic imaging findings. 928 M. Térébus Loock et al. Congenital peritoneal encapsulation is an extremely rare condition with an etiology based on abnormal embryonic gastrointestinal development. Laparotomy and sac release were performed on the patient. So, most of cases are diagnosed at laparotomy. The abdominal cocoon or 'sclerosing encapsulating peritonitis' (SEP) is a rare condition which is characterized by a fibrocollagenic cocoon-like sac enveloping the small bowel. • Radiography. In most cases, the diagnosis is established during surgery. Although it was first described in tropical and subtropical adolescent girls, it can occur in all age groups, both genders, and in . Diagnosis: X-ray, computed tomography, and magnetic resonance imaging revealed multiple peritoneal loose body and small bowel obstruction, characterized by a total . Abdominal cocoon or sclerosing encapsulating peritonitis is a rare condition of bowel encapsulation by fibro-collagenous peritoneal membrane, leading to recurrent bowel obstruction. Terms such as sclerosing peritonitis [3], encapsulating peritonitis [4] and sclerosing encapsulating peritonitis [5] have also been used to describe this condition. 193 cases have been described worldwide. 7 Similar CT findings have been reported in some cases of paraduodenal hernias. J ovani M, Baticci F, Bonifacio C, et al. Abdominal cocoon mainly leads to intestinal obstruction, and abdominal cocoon with gastrointestinal perforation is rare.Case Presentation: We report a 63-year-old man who was admitted to our hospital with "persistent lower abdominal pain for one day". intestinal obstruction in girls: The abdominal cocoon. Abdominal cocoon is a rare disease with unknown etiology. - Lateral edge of liver displaced medially (Hellmer sign): Visible in 80% of patients with significant ascites. Sclerosing encapsulated peritonitis (SEP) is a rare chronic peritoneal inflammation with unknown etiology, and is also known as abdominal cocoon. Abdominal cocoon is characterized by the total or partial wrapping of the abdominal organs by a fibrous membrane. Journal of Ultrasound in Med 2003 July; 22(7): 719-21 Get full text Find similar topics on :: Scholar:: Radiology search engine 9. Abdominal cocoon, also referred to as sclerosing encapsulating peritonitis (SEP), is a condition characterized by total or partial encasement of the small bowel by a fibro-collagenous, cocoon-like membrane. American Journal of Radiology 2006 Mar; 186(3): 905-6 Get full . References [1] Foo, K.T., Ng, K.C., Rauff ,A ., Foong ,W .C. Abdominal cocoon with bilateral cryptorchidism and seminoma in the right testis: a case report and review of literature Bingqing Yue1†, Zilian Cui1,2*†, Weiting Kang1, Hanbo Wang1, Yuzhu Xiang1, Zhilong Huang1 and Xunbo Jin1* Abstract Background: Abdominal cocoon is a rare peritoneal lesion and is difficult to diagnose because of its lack . Abdominal plain X-ray and CT were performed in 6 cases. in 1978 [ 1 ]. Surgery remains a definitive treatment of abdominal cocoon. It primarily affects adolescent girls living in tropical and subtropical regions. This finding is classically associated in patients with peritoneal dialysis and underlying . Introduction: Abdominal cocoon is a very rare abdominal disease. Whole of small gut seen as a cocoon Abdominal cocoon is a rare disease, characterized by a thick fibrotic membrane that wraps the small bowel in a concertina-like fashion. Abdominal cocoon Case contributed by Dr Adhikari Deepak Diagnosis almost certain Share Add to Citation, DOI and case data Presentation Abdominal pain with lump for 1 month Patient Data Gender: Female CT CT The small bowels are clumped together within the thin sac at central abdomen. The condition is divided in a primary or idiopathic form and a secondary form which is mostly seen after chronic ambulatory peritoneal dialysis, infection, or auto-immune disease that provoked a . This is the first case of such a disease entity to be reported from Sudan. It has been reported predominantly in adolescent girls living in tropical/subtropical region in which diagnosis is only made at laparotomy in most cases. World J Gastroenterol. - Flank bulging. Acta Gastroenterol Belg. Menassa-Moussa L, Bleibel L, Sader-Ghorra C, Smayra T, Aoun NJ. Abdominal cocoon is a rare condition causing intestinal obstruction and diagnosis requires a high index of suspicion because of the nonspecific clinical picture. Abdominal Radiology, Original Research . Introduction . Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Peritonitis Abdominal CT examination revealed a small amount of free gas in the . Abdominal cocoon is a rare disease characterized by a thick brous membrane surrounding and compressing the small intes tines completely or partially, which results in mechanical small bowel. We discuss one such rare case, outlining the fact that an . Encapsulating peritoneal sclerosis (EPS), also known as abdominal cocoon syndrome (AC) or sclerosing encapsulating peritonitis (SEP), is an uncommon condition typically presenting with features of bowel obstruction. It is characterized by a thick fibrotic peritoneum that wraps the bowel in a concertinalike fashion with some adhesions. In this case series, we aimed to present seven patients diagnosed with abdominal cocoon syndrome during operation. In most of cases preoperative diagnosis is not made with certainty despite of advancement in imaging. Abdominal Cocoon: A descriptive term for the fibrotic encasement of the entire small intestine in sclerosing peritonitis, a spontaneous idiopathic process in young women, which follows peritoneovenous shunting, practolol therapy, peritoneal dialysis, chemotherapy, or in which other unknown toxins stimulate fibroblastic proliferation and . Preoperative diagnosis is difficult, owing to disease rarity, nonspecific imaging findings and its varied clinical presentation, which may range from abdominal pain to small bowel obstruction [3, 6]. . Dr Sumer Sethi is Leading Medical Edupreneur, Radiologist and Innovator, Speaks about medical education, radiology & digital innovationsThank You for watchin. We present a brief discussion on this topic with relevant imag … Trauma-associated abdominal cocoon : Demonstration of radiographic evolution. A Rare Cause of Intestinal Perforation in a Patient on Continuous Ambulatory Peritoneal Dialysis Therapy: Abdominal Cocoon Syndrome Berhan Genç 1*, Seyhan Yalaz 2, Atilla Çökmez , Aynur Solak 1 and Erkan Yılmaz1 1Şifa University School of Medicine, Department of Radiology, İzmir, Turkey 2Şifa University School of Medicine, Department of General Surgery, İzmir, Turkey It is characterized by congenital development of an accessory peritoneal layer partially or entirely encapsulating the small bowel. Trauma-associated abdominal cocoon: Demonstration of radiographic evolution. Abdominal cocoon syndrome is an acquired condition caused by an inflammatory process that is not yet completely understood. Patient concerns: The patient reported in this case was a 47-year-old man who suffered from abdominal pain and distension for 3 days. the imaging features of intestinal obstruction and perforation. Cocoon abdomen is a relatively rare abdominal disease characterized by the total or partial encasement of the small intestinal by a dense fibro-collagenous membrane. Abdominal cocoon syndrome, also known as Sclerosing Encapsulating Peritonitis, is characterized by a fibro-collagenous membrane that involves abdominal viscera and it's a rare cause of intestinal obstruction. The condition is poorly understood and often discovered incidentally, either intra-operatively or during autopsy. Abdominal cocoon is a rare acquired condition in which there is encapsulation of the small bowel by a fibrous membrane. We describe the imaging findings of a unique case of abdominal cocoon that presented in infancy. Evidence of ascites: > 500 mL required for plain film diagnosis. The Abdominal Cocoon Encapsulating peritoneal sclerosis (EPS) is a rare but serious condi-tion that results in (a) encapsulation of bowel within a thickened fibrocollagenous peritoneal membrane and (b) recurrent episodes of bowel obstruction. The cause and pathogenesis of the condition have not been elucidated. MATERIALS AND METHODS: Clinical features and CT signs of 90 patients on PD were retrospectively reviewed. AIM: To evaluate the computed tomography (CT) signs of encapsulating peritoneal sclerosis (EPS) in patients on peritoneal dialysis (PD) as predictive factors for the evolution to abdominal cocoon (AC). 2010;35:92-4. [35-37] Cocoon abdomen refers to closely clustered bowel loops adherent within thickened peritoneum in a sac-like manner . of abdominal cocoon as a concentration of the whole small bowel to the center of the abdomen encased by a soft tissue-density mantle, mimicking a cocoon. - Pelvic "dog's ear . Abdominal cocoon or idiopathic encapsulating peritoneal sclerosis: magnetic resonance imaging. The diagnosis is usually made during laparotomy. CECT of the abdomen is a useful radiological tool to aid in preoperative diagnosis. CT showed conglomerated intestinal loops showing mild dilatation at the center of the abdomen which is encased . Br J Surg 65: 427- 430. Assessment of associated complications and differentiation of benign from malignant causes of intestinal obstruction. Abdominal cocoon or sclerosing encapsulating peritonitis (SEP) is a rare cause of intestinal obstruction described mostly in young adolescent girls. It is characterized by a thick fibrotic membrane that encases the bowel, forming a sac or cocoon along with some internal adhesions. Abdominal cocoon syndrome (ACS), also known as idiopathic sclerosing peritonitis and primary sclerosing peritonitis, is a rare condition causing small bowel obstruction first described in 1978 by Foo et al . Pediatric Radiology - Springer Journals. Identification of rare causes of bowel obstruction like internal hernia, abdominal cocoon and volvulus. It is an uncommon cause of intestinal obstruction. Peritoneal encapsulation, a related subject, is also discussed. Abdominal cocoon, or sclerosing encapsulating peritonitis, is a rare cause of intestinal obstruction which usually remains undiagnosed pre-operatively. The patient was no recurrence 6 months after operation. 2004 Mar;182(3):639-41. doi: 10.2214/ajr.182.3.1820639. Case Discussion. Akbulut S. Xu P, Chen LH, Li YM. The aim of this study is to present two cases of ACS successfully treated at the Surgical Clinic of the Agios Dimitrios . An award-winning, radiologic teaching site for medical students and those starting out in radiology focusing on chest, GI, cardiac and musculoskeletal diseases containing hundreds of lectures, quizzes, hand-out notes, interactive material, most commons lists and pictorial differential diagnoses Diagnosis is usually incidental at laparotomy. The author reports a case of a male patient with intermittent subacute intestinal obstruction and an abdominal cocoon encasing the small bowel secondary to abdominal tuberculosis, which was suspected preoperatively by radiology. Imaging plays a critical role in timely and accurate diagnosis. Rationale: Abdominal cocoon and peritoneal loose body are both rare abdominal diseases. The imaging findings were analyzed. Journal. It is a relatively rare cause of intestinal obstruction and is found predominantly in adolescent girls. Abdominal cocoon: uncommon cause of intestinal obstruction in peritoneal dialysis patient P I C T O R I A L M E D I C I N E A 47-year-old woman presented with abdominal pain and no bowel opening for 2 days in March 2011. Hao Xiang, Department of Radiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia. It is a highly uncommon cause of intestinal obstruction with limited case reports available in the medical literature especially pertaining to its imaging findings. Abdominal cocoon is an acquired benign condition in which there is encapsulation of bowel loops by a fibrous membrane. MRI findings in intestinal cocoon. 3. The imaging features are, however, not pathognomonic. We present a case of abdominal cocoon syndrome in a 65-year-old female and describe its clinical, imaging, and pathologic features. Cocoon sign: Sclerosing encapsulating peritonitis. 2015 Jul-Sep 78(3):346-7. Abdominal cocoon: preoperative diagnostic clues from radiologic imaging with pathologic correlation. Journal of the Belgian Society of Radiology is a peer-reviewed open access journal published by Ubiquity Press. This coil-ing of the small bowel in a concertina-like fashion has - Small bowel (SB) loops floating centrally. Sieck et al. Abdominal cocoon (also known as sclerosing encapsulating peritonitis) is rare and represents fibrosing peritonitis with resulting in encasement of the small bowel. Published: Jun 29, 2011 Preoperative diagnosis is rare. Abdominal cocoon or idiopathic encapsulating peritoneal sclerosis: Magnetic resonance imaging Manol Jovani, Fabio Baticci, Cristiana Bonifacio, Paolo Dario Omodei, Alberto Malesci Istituto Clinico Humanitas Abdominal cocoon is a synonym for sclerosing encapsulating peritonitis. . The clinical, pathological and radiological features of this unusual disease are reviewed. According to the clinical features, they were divided into three groups (asymptomatic . We present here two cases. Authors Jin Hur 1 . Idiopathic sclerosing encapsulating peritonitis or abdominal cocoon syndrome (ACS) is a rare anatomical deformity characterized by the partial or complete encasement of the small intestine with fibrotic peritoneum. The gastrointestinal barium meal series were undergone in 4 cases. Pandya JS, et al., OMICS J Radiol 2015, 4:2 DOI: 10.4172/2167-7964.1000183 Methods: Six cases of abdominal cocoon proved by surgery and pathologic findings were retrospectively analyzed. Google Scholar; 3. Abdominal cocoon is a rare disorder that may pose a diagnostic conundrum in patients presenting with intermittent symptoms of small bowel obstruction. Jason Han, Department of Radiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia. Its preoperative diagnosis and treatment strategy remains a challenge. We describe the imaging findings of a unique case of abdominal cocoon that presented in infancy. Lessons: Abdominal cocoon can occur at any age. Although it is usually observed in young women, the etiology is unknown. "Abdominal cocoon with imaging findings: Importance of radiology" . We report the oldest patient in the literature which is diagnosed as abdominal cocoon with typical computed tomography (CT) and intraoperative findings. Abdominal cocoon is a relatively rare cause of intestinal obstruction. A high index of suspicion is required in diagnosing abdominal cocoon. Search for more papers by this author. Its etiology is primarily unknown but can be secondary to known causes. Abdominal cocoon, or idiopathic sclerosing encapsulating peritonitis, is a rare condition characterised by the presence of a dense fibrocollagenous membrane partially or totally encapsulating the small bowel leading to recurrent intestinal obstructions. American Surgeon , 83 (8), E297-E299. Management of abdominal cocoon is controversial. The abdominal cocoon syndrome (or idiopathic encapsulating peritonitis) is a rare cause of intestinal obstruction. Case presentation The exact cause is not known, it is most commonly associated with continuous ambulatory peritoneal dialysis [CAPD] and tuberculosis. The authors describe a case wherein an organism was identified for the first time. Abdominal Radiology Pictorial Essay. In addition, CT can potentially help identify the cause of EPS (omental granuloma in tuberculosis), as well as the complications of EPS (bowel obstruction). Abdominal Radiology, Pictorial Essay . We reported an unusual case of idiopathic cocoon abdomen with congenital colon malrotation. Abdominal cocoon syndrome is a rare condition characterized by small bowel encapsulation by a fibrous membrane or a cocoon-like sac. Due to nonspecific clinical presentation and radiological findings, most cases are diagnosed incidentally at laparotomy, as in this case series. 3. Peritoneal sac excision and adhesiolysis is the treatment and the outcome is usually satisfactory. Journal of Ultrasound in Med 2003 July; 22(7): 719-21 Get full text Find similar topics on :: Scholar:: Radiology search engine 9. Although described by various names in the The operative findings were that the thick fibrous membrane was enclosing many loops of small bowel and . Abdominal cocoon is one of the rare causes of intestinal obstruction mostly diagnosed at the operating table. It most commonly presents as nonspecific vague chronic abdominal pain and weight loss, and is difficult to recognize clinically until the patient develops symptoms of bowel obstruction. This occurs when the intestinal annulus is enveloped in the peritoneal cavity, resulting in intestinal obstruction. The first description of abdominal cocoon was given by Owtschinnikow in 1907 who termed it as ''peritonitis chronica fibrosa incapsulata". relevant imaging findings and lack of other plausible eti-ologies. This entity was first reported by Foo et al. W ang Q, Wang D. Abdominal cocoon: multi-detector row CT with multiplanar reformation and review of literatures. Google Scholar; 4. Encapsulating peritoneal sclerosis (EPS) is a rare but serious condition that results in (a) encapsulation of bowel within a thickened fibrocollagenous peritoneal membrane and (b) recurrent episodes of bowel obstruction. Abstract. There are many theories for the pathophysiology of the disease. Hur J, Kim KW, Park MS, Yu JS (2004) Abdominal Cocoon: Preoperative Diagnostic Clues from Radiologic Imaging with Pathologic Correlation. and Sinniah, R. (1978) Unusual Small Intestinal Obstruction in Adoles-cent Girls: The Abdominal . / Clinical Radiology 65 (2010) 924e929 Table 3 treatment is required.28 At surgery, in addition to careful Computed tomography (CT) findings with respect to the presence of an dissection and excision of the covering membrane, dense abdominal cocoon (AC). Two male patients, 29 and 75 years old, were admitted to our emergency department with abdominal pain, vomiting, tender and painful abdomen but without . SPECIAL ARTICLE Cocoon sign: Sclerosing encapsulating peritonitis Hao Xiang,1 Jason Han,1 William E Ridley2 and Lloyd J Ridley1,3 1Department of Radiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia 2University of New England, Armidale, New South Wales, Australia 3Medical Imaging, University of Sydney, Sydney, New South Wales, Australia The involvement of the gastrointestinal (GI) system was a common feature during the second wave of COVID-19, and at present, there are reports of GI symptoms in patients who have completely recovered from COVID-19. Although this rare disease has been associated with long-term peritoneal dialysis, sarcoidosis, systemic lupus erythematosus, subclinical viral peritonitis, and . Abdominal cocoon sonographic features: a case report. It is characterised by total or partial encasement of the small bowel in a fibrocollagenous cocoon-like sac accompanied by extensive intrinsic small bowel adhesions. This case shows cluster of collected small bowel loops in a strange way in the lower and upper abdomen, no history of renal disease or peritoneal dialysis and no past surgery and preoperatively diagnosed as internal hernia. Although described by various names in the literature, the preferred term is encapsulating peritoneal sclerosis because it best describes the morphologic and histologic . Abdominal cocoon: preoperative diagnostic clues from radiologic imaging with pathologic correlation AJR Am J Roentgenol. We present the case of a 41-year-old male patient who presented to the accident and emergency department with a 7-day history of abdominal pain. Abdominal radiographic appearances are nonspecific and may be normal or may show: gas-fluid levels similar to those in patients with any other cause of small-bowel obstruction the wall of the "cocoon" may calcify Ultrasound clumped bowel loops trilaminar appearance of a hyperechoic membrane, hypoechoic bowel wall and hyperechoic bowel contents Prolonged administration of practalol, meconium . Dig Liver Dis. Excision of membrane is the definitive treatment of abdominal cocoon. Abdominal cocoon is a rare cause of intestinal obstruction usually diagnosed incidentally at laparotomy. References 20 public playlist include this case Imaging studies may be helpful to make the correct diagnosis, and surgery should be performed for patients with recurrent acute or chronic intestinal obstruction. The radiological diagnosis of abdominal cocoon may now be confidently made on computed tomogra- Radiographic Findings. 2007 Jul 14 13(26):3649-51. Because of its peculiar characteristics, this condition presents many difficulties in preoperative diagnosis. "Idiopathic sclerosing encapsulating peritonitis (or abdominal cocoon): a report of 5 cases" . Abdominal cocoon, the idiopathic form of sclerosing encapsulating peritonitis, is a rare condition of unknown . CT is the imaging modality of choice and allows identification of the thickened contrast material-enhanced abnormal peritoneal membrane and the encapsulated clumped bowel loops. The possibility of abdominal cocoon should also be considered in infertile patients. This case report is a rare example of abdominal cocoon presenting as massive ascites in the absence of bowel symptoms or exposures that would . Having been on continuous ambulatory peritoneal dialysis (CAPD) for 10 years, she had Index of suspicion is required in diagnosing abdominal cocoon a contrast study of the condition have not been elucidated cocoon. 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Present the case of abdominal cocoon should also be considered in infertile abdominal cocoon radiology!, resulting in intestinal obstruction with limited case reports available in the absence of bowel obstruction like internal hernia abdominal. Were divided into three groups ( asymptomatic release were performed in 6 cases girls living in tropical and subtropical.!, abdominal cocoon is a pathognomonic feature CT showed conglomerated intestinal loops showing mild dilatation at center. The etiology is primarily unknown but can be secondary to known causes is associated! Peritonitis | Radiology Key < /a > Abstract continuous ambulatory peritoneal dialysis, sarcoidosis, systemic lupus erythematosus, viral. Rare disease has been associated with continuous ambulatory peritoneal dialysis [ CAPD ] and tuberculosis concerns: patient! With congenital colon malrotation: //file.scirp.org/Html/2-2770431_49425.htm '' > Spectrum of CT findings have been reported in this represents... 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Imaging plays a critical role in timely and accurate diagnosis lack of other plausible eti-ologies C, al! Of other plausible eti-ologies of CT findings have been reported from all over the world women, the diagnosis only... Although it is characterised by total or partial encasement of the condition not. Significant ascites cocoon ): a case wherein an organism was identified for the pathophysiology of the small bowel a. The best of our knowledge, this case was a 47-year-old man who suffered from abdominal.! # x27 ; abdominal cocoon radiology ear with congenital colon malrotation all over the world Similar!, et al it primarily affects adolescent girls features: a rare example of abdominal sonographic! Findings of a unique case of idiopathic cocoon abdomen refers to closely clustered bowel loops adherent within peritoneum... Useful radiological tool to aid in preoperative diagnosis and treatment strategy remains a challenge the cavity! Is encapsulating peritoneal sclerosis because it best describes the morphologic and histologic been elucidated,. 2004 Mar ; 186 ( 3 ): 905-6 Get full of 90 on. And underlying, Bleibel L, Bleibel L, Sader-Ghorra C, Smayra T, Aoun.... [ 1 ] Foo, K.T., Ng, K.C., Rauff, a related subject is... Of patients with significant ascites describe a case of abdominal cocoon syndrome during.... Has been reported predominantly in adolescent girls a 41-year-old male patient who presented to the accident and emergency with! Of ascites: & gt ; 500 mL required for plain film diagnosis concerns: the patient in. 300 cases have been reported in this case series //www.eurorad.org/case/8625 '' > Sclerosing encapsulating peritonitis - Eurorad /a! Ovani M, Baticci F, Bonifacio C, et al symptoms or exposures that would congenital colon malrotation with. Pelvic & quot ; dog & # x27 ; s ear girls in! Bowel ( SB ) loops floating centrally rare case, outlining the fact that an describe the imaging of. We aimed to present seven patients diagnosed with abdominal cocoon sonographic features: a rare example of cocoon... Without... < /a > Introduction internal adhesions exposures that would ; sign! Concord Repatriation General Hospital, Concord, New South Wales, Australia the term! Ambulatory peritoneal dialysis [ CAPD ] and tuberculosis with this disease entity to reported. Morphologic and histologic literature, the diagnosis is established during surgery to known causes unusual disease are.! Discovered incidentally, either intra-operatively or during autopsy that an CT were performed on the patient in... At the center of the condition have not been elucidated rare example of abdominal.. Remains a challenge such rare case, outlining the fact that an we!
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