Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 28, 2016; 22(20): 4958-4962
Published online May 28, 2016. doi: 10.3748/wjg.v22.i20.4958
Idiopathic abdominal cocoon syndrome with unilateral abdominal cryptorchidism and greater omentum hypoplasia in a young case of small bowel obstruction
Xiang Fei, Hai-Rui Yang, Peng-Fei Yu, Hai-Bo Sheng, Guo-Li Gu
Xiang Fei, Hai-Rui Yang, Peng-Fei Yu, Guo-Li Gu, Department of General Surgery, the Air Force General Hospital, Chinese PLA, Beijing 100142, China
Hai-Bo Sheng, Department of Urinary Surgery, the Air Force General Hospital, Chinese PLA, Beijing 100142, China
Author contributions: Gu GL designed the research; Gu GL, Yang HR, Sheng HB and Fei X performed the research; Fei X and Yu PF collected and analyzed the data; Gu GL and Fei X wrote the paper; and Gu GL revised the paper.
Supported by Major Projects of Chinese PLA “13th Five-Year Plan” Logistics Research Subject, No. AKJ15J003.
Institutional review board statement: This work has been carried out in accordance with the Declaration of Helsinki (2000) of the World Medical Association. This study was approved ethically by Ethics Committee of the Air Force General Hospital, PLA.
Informed consent statement: The patient involved in this study gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: All the authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Guo-Li Gu, Associate Professor, Deputy Director, Department of General Surgery, the Air Force General Hospital, Chinese PLA, No.30, Fucheng Road, Haidian District, Beijing 100142, China. kzggl@163.com
Telephone: +86-10-66928303 Fax: +86-10-66928303
Received: February 14, 2016
Peer-review started: February 14, 2016
First decision: March 7, 2016
Revised: March 15, 2016
Accepted: April 7, 2016
Article in press: April 7, 2016
Published online: May 28, 2016
Processing time: 95 Days and 14.1 Hours
Abstract

Abdominal cocoon syndrome (ACS) is a rare cause of intestinal obstruction due to total or partial encapsulation of the small intestine by a fibrocollagenous membrane. Idiopathic ACS with abdominal cryptorchidism and greater omentum hypoplasia is even rarer clinically. We successfully treated a 26-year-old male case of small bowel obstruction with acute peritonitis. He was finally diagnosed with idiopathic ACS with unilateral abdominal cryptorchidism and greater omentum hypoplasia during exploratory laparotomy. He then underwent enterolysis, cryptorchidectomy, and appendectomy. He recovered gradually from the operations and early postoperative inflammatory ileus. There has been no recurrence of intestinal obstruction since the operation, and he is still in follow-up. We analyzed his clinical data and retrospectively reviewed the literature, and our findings may be helpful for the clinical diagnosis and treatment on ACS.

Keywords: Abdominal cocoon syndrome; Abdominal cryptorchidism; Intestinal obstruction; Diagnosis; Treatment

Core tip: Abdominal cocoon syndrome (ACS) is a rare abdominal disease where a portion or all of the abdominal organs are wrapped in a dense membrane-like fibrous tissue. Intestinal obstruction is the main clinical manifestation of ACS. Because of its rarity and lack of characteristic symptoms, ACS is fairly difficult to diagnose pre-operatively. Surgeons should be aware of this disease when confronted with a case of intestinal obstruction whose abdominal radiography shows intestinal loop aggregation cluster. Accompanying cryptorchidism is possible, and a careful physical examination and operative exploration for the undescended testicle should be performed. Postoperative care and dietary guidance are very important to the rehabilitation of ACS patients. Postoperative re-adhesion and early postoperative inflammatory ileus easily occur after extensive enterolysis.