Abdominal cocoon syndrome in a 10-year-old young adolescent after abdominal operation: A case report and review of literature

Abstract

BACKGROUND

Sclerosing encapsulating peritonitis (SEP), also known as abdominal cocoon syndrome, is rare in children. The etiology of primary SEP is believed to be associated with retrograde menstruation or viral peritonitis in young adolescent girls, whereas secondary SEP refers to SEP caused by other factors such as surgery, peritoneal dialysis, or tuberculosis. Secondary SEP is rare and lack diagnostic specificity in children. Given the potential to cause acute intestinal obstruction, surgical intervention is often required.

CASE SUMMARY

We report the case of a 10-year-old girl with secondary SEP who was admitted to our center with acute bowel obstruction.

CONCLUSION

In this report, we emphasized the imaging manifestations, diagnosis, and operative management of the case. Although postoperative SEP in children is rare, the long-term prognosis is favorable when accompanied with accurate diagnosis, appropriate perioperative management, and timely follow-up.

Keywords: Abdominal cocoon syndrome; Child; Intestinal obstruction; Pediatric surgery; Sclerosing encapsulating peritonitis; Case report

Core Tip: Sclerosing encapsulating peritonitis (SEP) (abdominal cocoon syndrome), a rare etiology of pediatric intestinal obstruction, is predominantly secondary to prior abdominal surgery, peritoneal dialysis, or tuberculosis. Characterized by non-specific clinical presentations, it poses diagnostic challenges in children and frequently progresses to mechanical bowel obstruction. We present a 10-year-old female with postoperative SEP, highlighting its distinctive imaging features (including "cocoon-like" peritoneal encapsulation on computed tomography), intraoperative confirmation via adhesiolysis, and successful multi-disciplinary management. This case underscores the critical role of early radiological suspicion and surgical intervention in mitigating morbidity, while providing insights for differentiating SEP from other adhesive pathologies in pediatric populations.