Abdominal cocoon syndrome presenting as acute small bowel obstruction: Report of a case

Abdominal cocoon syndrome presenting as acute small bowel obstruction: Report of a caseTo the Editor, Abdominal cocoon syndrome (ACS), or sclerosing encapsulating peritonitis (SEP), is a rare condition characterized by encapsulation of the small bowel within a fibrocollagenous membrane, causing acute or recurrent intestinal obstruction. 1 ACS is classified into primary (idiopathic) and secondary types.Secondary ACS has well-recognized etiologies including peritoneal dialysis, abdominal tuberculosis, prior surgery, and beta-blocker use, whereas primary ACS occurs without identifiable precipitating factors.1,2 We report a case of primary ACS presenting as acute complete small bowel obstruction.A 59-year-old man presented with sudden-onset persistent abdominal pain and distension, nausea, vomiting, and a 6-h history of cessation of flatus and bowel movements.He had no history of abdominal surgery, peritoneal dialysis, tuberculosis, or longterm medication use.Examination revealed distension of the mid and lower abdomen (Fig. 1a), palpable firm masses in the right Asian Journal of Surgery xxx (xxxx) xxx