Cocoon Syndrome: A Rare Cause of Bowel Obstruction Revealing Hidden Intestinal Tuberculosis

Abstract

Abdominal cocoon syndrome, also known as sclerosing encapsulating peritonitis (SEP), is characterized by the entrapment of intestinal loops by a fibrous membrane and is a rare cause of small bowel obstruction. We report a rare case of SEP secondary to intestinal tuberculosis in a 35-year-old male patient with no relevant medical history. He presented with symptoms suggestive of bowel obstruction, including acute abdominal pain, vomiting, and abdominal distension. Imaging showed pneumoperitoneum and encapsulation of the small intestine, while surgery revealed a fibrous capsule surrounding the bowel. Histopathological examination confirmed intestinal tuberculosis with granulomatous inflammation and caseating necrosis. Treatment involved surgical resection, ileostomy, and antitubercular therapy. This case emphasizes the importance of considering abdominal tuberculosis in the differential diagnosis of SEP.