Jarrad Bashar, Ayasa Laith A, Abboushi Mohammed B, Judeh Khaled A, Almasry Nadeem, Hamayel Kamal A, Khader Abdellatif
General Surgery, Palestine Medical Complex, Ramallah, PSE.
Internal Medicine, Al-Quds University, Jerusalem, PSE.
Cureus. 2023 Jul 22;15(7):e42289. doi: 10.7759/cureus.42289. eCollection 2023 Jul.
Primary sclerosing encapsulating peritonitis (PSEP), also known as abdominal cocoon syndrome, is a rare condition characterized by small bowel encapsulation by a fibrous membrane or a cocoon-like sac. It is an uncommon cause of intestinal obstruction, as less than 300 cases have been reported from all over the world. We present the case of a 57-year-old male patient who presented with acute abdominal pain, nausea, vomiting, and constipation. A trial of conservative management failed, which warranted surgical intervention. Adhesiolysis was done, resulting in the relief of the intestinal obstruction caused by cocoon syndrome. The patient experienced excellent clinical improvement postoperatively and remained symptom-free during follow-up. Primary sclerosing encapsulating peritonitis poses a diagnostic challenge due to its rarity and nonspecific clinical presentation. A high index of suspicion, a thorough history review, a physical examination, and imaging studies are crucial for an accurate diagnosis. This case report emphasizes the importance of recognizing abdominal cocoon syndrome as a potential cause of intestinal obstruction and highlights the successful management of the condition. This is the first case of such a disease entity to be reported from Palestine.
原发性硬化性包裹性腹膜炎（PSEP），也称为腹腔茧状包裹综合征，是一种罕见疾病，其特征为小肠被纤维膜或茧状囊包裹。它是肠梗阻的罕见病因，全世界报道的病例不足300例。我们报告一例57岁男性患者，该患者出现急性腹痛、恶心、呕吐及便秘。保守治疗试验失败，因此需要手术干预。进行了粘连松解术，解除了由茧状综合征引起的肠梗阻。患者术后临床症状明显改善，随访期间无症状。原发性硬化性包裹性腹膜炎因其罕见性和非特异性临床表现而带来诊断挑战。高度的怀疑指数、全面的病史回顾、体格检查及影像学检查对于准确诊断至关重要。本病例报告强调了认识腹腔茧状包裹综合征作为肠梗阻潜在病因的重要性，并突出了该疾病的成功治疗。这是巴勒斯坦首次报道的此类疾病病例。
