Umbish Dino, MBBS; Ahamed Lazim Vattoth, MD; Jeremy Smith, MD
WMJ. 2025;124(5):478-481.
ABSTRACT
Introduction: Abdominal cocoon syndrome, or sclerosing encapsulating peritonitis, is a rare condition characterized by the encasement of the small bowel in a dense fibrocollagenous membrane, often mimicking symptoms of bowel obstruction. Secondary ACS associated with malignancy is exceptionally uncommon.
Case presentation: A 44-year-old man with a history of ascites presented with intractable nausea, vomiting and severe cachexia. The diagnostic process posed significant challenges, requiring advanced imaging and invasive interventions to uncover the underlying malignancy.
Discussion: This case highlights the diagnostic challenges of secondary abdominal cocoon syndrome, emphasizing the importance of maintaining high clinical suspicion and utilizing advanced diagnostic tools in complex presentations.
Conclusions: Early recognition, advanced imaging, and a multidisciplinary approach are critical to optimizing outcomes in rare and challenging conditions.
Author affiliations: Department of Internal Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Dino, Vattoth, Smith).
Corresponding author: Ahamed Lazim Vattoth, MD; University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-0001; email vattoth@wisc.edu; ORCID ID 0009-0009-2570-8025
Financial disclosures: None declared.
Funding/support: None declared.
Share WMJ