scholarly journals Tuberculous Abdominal cocoon in childern– A Single Centre Study in remote area in northern India

2017 ◽  
Vol 90 (2) ◽  
pp. 179-184 ◽  
Author(s):  
Rikki Singal ◽  
Satyashree B ◽  
Amit Mittal ◽  
Bhanu Pratap Sharma ◽  
Samita Singal ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Medical Sciences ◽  
Abdominal Cocoon ◽  
Northern India ◽  
Single Centre Study ◽  
Encapsulating Peritonitis ◽  
Operative Findings ◽  
A Prospective Study ◽  
Tomography Scan

Background. Amongst the numerous causes of intestinal obstruction listed in the literature, sclerosing encapsulating peritonitis also called Abdominal Cocoon (AC) is one of the rarest entities. Its characteristic feature is a thick fibrotic membrane encasing varying lengths of the small and large gut in a cocoon. In India, there is an increasing incidence of tuberculosis, especially in the rural areas.Aims and objectives. The aim of this study was to investigate the clinical presentation and evaluate the operative findings of tuberculous AC. We also evaluated the outcomes and response to anti tuberculous treatment (ATT) in all the patients diagnosed with this condition.Material and methods. This study was carried out at M.M. Institute of Medical Sciences and Research, Mullana, Ambala, India between April 2013 – March 2016 in the Department of Pediatric Surgery. This is a prospective study. A total of 17 patients diagnosed with abdominal cocoon secondary to tuberculosis have been included in the study.Results. A total of 17 patients presented to the emergency ward with features of acute intestinal obstruction. The average age was 15.3 years (range 9 years to 16 years). There were 14 females and 3 males. All patients presented with abdominal pain, bilious vomiting, constipation and abdominal distention. The patients were operated in our hospital and relieved of their obstruction. Based on their operative findings and after histopathological confirmation, patients were given ATT. In the follow-up, all patients did well, without recurrence of tuberculosis or intestinal obstruction. Conclusion. Tuberculosis as a cause of childhood AC is rather common in developing countries and is potentially a fatal condition. A strong clinical suspicion, sonographic and computed tomography scan findings help establish a pre-operative diagnosis. Tuberculous AC has a strong prevalence in females.  Surgery is the mainstay of treatment followed by anti-tuberculous drugs.

scholarly journals Multiple Abdominal Cocoons: An Unusual Presentation of Intestinal Obstruction and a Diagnostic Dilemma

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Mohammad Zain Sohail ◽  
Shumaila Hasan ◽  
Benan Dala-Ali ◽  
Shahanoor Ali ◽  
M. A. Hashmi
Keyword(s):  
Intestinal Obstruction ◽  
Abdominal Cavity ◽  
Fibrous Membrane ◽  
Unknown Aetiology ◽  
Abdominal Cocoon ◽  
Diagnostic Dilemma ◽  
Previous Abdominal Surgery ◽  
History Of ◽  
Subacute Intestinal Obstruction ◽  
Encapsulating Peritonitis

Sclerosing encapsulating peritonitis (SEP) or abdominal cocoon is a rare acquired condition with an unknown aetiology. It is characterized by encapsulation of the small bowel by a fibrous membrane and can lead to intestinal obstruction. We present the case of a 42-year-old gentleman with a history of hepatitis C, tuberculosis, and previous abdominal surgery, who presented with subacute intestinal obstruction. Surgical exploration of the abdomen revealed that the entire contents were enclosed into three distinct sacs by a dense fibrous membrane. Excision of the sacs was performed followed by adhesiolysis. This is believed to be the first reported case of multiple cocoons within the abdominal cavity. The case is discussed with reference to the literature.

scholarly journals Difficult to Diagnose the Cause of Intestinal Obstruction due to Abdominal Cocoon Syndrome

2021 ◽  
Author(s):  
Cemal Ulusoy ◽  
Andrej Nikolovski ◽  
Nazım Öztürk
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Abdominal Mass ◽  
Clinical Signs ◽  
Rare Condition ◽  
Abdominal Cocoon ◽  
Sclerosing Encapsulating Peritonitis ◽  
Encapsulating Peritonitis ◽  
Palpable Abdominal Mass

Abdominal cocoon syndrome (sclerosing encapsulating peritonitis) is a rare condition associated with clinical signs of intestinal dysfunction, episodes of small bowel obstruction and sometimes a palpable abdominal mass. We present the case of a 46-year-old male patient with clinical signs of intestinal obstruction caused by primary sclerosing encapsulating peritonitis.

scholarly journals Abdominal Cocoon Syndrome (Idiopathic Sclerosing Encapsulating Peritonitis): How Easy Is Its Diagnosis Preoperatively? A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Julius A. A. Awe
Keyword(s):  
Intestinal Obstruction ◽  
Adolescent Girls ◽  
Female Genital Tract ◽  
Complete Recovery ◽  
Tuberculous Infection ◽  
Prolonged Administration ◽  
Abdominal Cocoon ◽  
Benign Condition ◽  
Encapsulating Peritonitis ◽  
Female Genital

The abdominal cocoon syndrome (or idiopathic encapsulating peritonitis) is a rare cause of intestinal obstruction. It has been reported predominantly in adolescent girls living in tropical/subtropical region in which diagnosis is only made at laparotomy in most cases. The cause and pathogenesis of the condition have not been elucidated. Prolonged administration of practalol, meconium peritonitis, and tuberculous infection of the female genital tract have been incriminated as possible causes. The author reports a case of a female patient with recurrent intestinal obstruction treated for years but failed to settle down on conservative treatment during her last hospital admission and had to undergo surgery. Preoperative diagnosis of this syndrome as the cause of her intestinal obstruction was not made until at laparotomy, when a thick fibrotic peritoneal wrapping of the bowel in a concertina-like fashion with some adhesions was found. Excision of this membrane and adhesiolysis were carried out without any need for bowel resection, and this led to relief of the obstruction and patient’s complete recovery. Awareness of this benign condition in the differential diagnosis of intestinal obstruction will result in early diagnosis and correct management and prevent unnecessary bowel resections and bad outcomes.

scholarly journals A prospective study on emergency laparoscopic or open cholecystectomy in acute cholecystitis in a tertiary care hospital

2019 ◽  
Vol 6 (7) ◽  
pp. 2525
Author(s):  
Hari Babu M. A. ◽  
Hareesh G. S. R. ◽  
Praneeth Reddipogu ◽  
Venkata Ramanaiah Nannam
Keyword(s):  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Tertiary Care ◽  
Gallbladder Wall ◽  
Good Prognosis ◽  
Care Hospital ◽  
Medical College ◽  
Single Centre Study ◽  
Operative Findings ◽  
A Prospective Study

Background: Gallstones are among one of the most common diseases affecting the digestive system requiring hospitalisation with a prevalence of 11% to 36%. Until 2 decades ago, patients presenting with acute cholecystitis were treated conservatively and a delayed interval cholecystectomy was performed after 6 weeks, now a days laparoscopic cholecystectomy was gaining popularity in acute cholecystitis. It cannot be said with certainty preoperatively whether the cholecystectomy is going to be easy or difficult. The aim of the study was to evaluate safety and outcomes of emergency laparoscopic or open cholecystectomy in acute cholecystitis.Methods: This is a prospective, observational, single centre study conducted in the Department of General Surgery, S.V. Medical College/ SVRRGG hospital, Tirupati, for a period of one year from the time of approval of IEC. All patients undergoing emergency laparoscopic or open cholecystectomy for acute cholecystitis and its related complications are studied for various clinical, radiological and other variables.Results: Total 100 patients who presented with acute cholecystitis and undergone cholecystectomy are studied. Age, sex, BMI, comorbities, clinical and usg criteria and intra-operative findings and post-operative complications are analysed.Conclusions: Difficult dissection in cholecystectomy can be predicted using pre-operative parameters like increasing age, male gender, multiple attacks in the past, gallbladder wall thickness >3 mm, and presence of pericholecystic fluid. Surgery performed within 72 hrs had good prognosis and few intra op complications due to good place of dissection due to inflammation.

scholarly journals Abdominal cocoon: preoperative diagnosis on CT

2019 ◽  
Vol 12 (5) ◽  
pp. e229983
Author(s):  
Sudipta Mohakud ◽  
Aparna Juneja ◽  
Hira Lal
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Ct Scan ◽  
Preoperative Diagnosis ◽  
Abdominal Cocoon ◽  
Pulsatile Mass ◽  
Contrast Enhanced Ct ◽  
History Of ◽  
Subacute Intestinal Obstruction ◽  
Encapsulating Peritonitis

A 23-year-old man presented to the emergency department with a history of recurrent episodes of subacute intestinal obstruction. Palpation revealed a firm, non-tender, mobile, non-pulsatile mass of size 8–10 cm with indistinct margins and smooth surface in the hypogastrium. Contrast-enhanced CT scan of the abdomen showed clumping of the small bowel loops within a well-defined membrane-like structure without dilatation or thickening of bowel loops. The patient underwent a laparotomy with incision of the membrane and separation of all the small bowel loops inside the cocoon. Abdominal cocoon is the idiopathic variety of sclerosing encapsulating peritonitis and is an unusual cause of acute or subacute intestinal obstruction. Clinical diagnosis is difficult because of non-specific symptoms. CT has facilitated accurate preoperative diagnosis, long before the patient presents with full-fledged symptoms of acute intestinal obstruction. CT scan plays a significant role in excluding the secondary causes and helps in patient management.

Abdominal Cocoon: A Potential Pitfall in Patients with Ovarian Carcinoma

2012 ◽  
Vol 98 (6) ◽  
pp. e176-e178 ◽  
Author(s):  
Rut Isacson ◽  
Amiel Segal ◽  
Joseph Alberton ◽  
Constantin Reinus ◽  
Alon Schwarz ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Cancer Patients ◽  
Rare Condition ◽  
Unusual Complication ◽  
Abdominal Cocoon ◽  
Case Presentation ◽  
Sclerosing Encapsulating Peritonitis ◽  
Encapsulating Peritonitis

Background Abdominal cocoon, or sclerosing encapsulating peritonitis, is a rare condition characterized by partial or total encasement of small bowel and mesentery by a thick fibrocollagenous sack that looks like a cocoon. Within the sack, bowel loops are drawn together causing intestinal obstruction. Case presentation We report on a 57-year-old female patient who developed a very unusual complication of ovarian cancer: abdominal cocoon formation. Conclusions This report highlights the need for a timely diagnosis of sclerosing encapsulating peritonitis in cancer patients.

scholarly journals Comparison of efficacy of mirabegron and darifenacin in overactive bladder- a prospective study

2020 ◽  
Vol 8 (1) ◽  
pp. 196
Author(s):  
Gurpreet Singh Bhangu ◽  
Kamal Preet Kaur ◽  
Darpan Bansal ◽  
Ritansh Bansal
Keyword(s):  
Overactive Bladder ◽  
Drug Treatment ◽  
Comparative Study ◽  
Prospective Study ◽  
Treatment Options ◽  
Signs And Symptoms ◽  
Medical Sciences ◽  
Once Daily ◽  
A Prospective Study

Background: Overactive bladder (OAB) is under reported yet distressing symptoms which can be managed effectively by the drugs available. Aim was to study and compare the efficacy of two drugs, mirabegron and darifenacin in controlling the symptoms of overactive bladder.Methods: This prospective study included a total of 120 cases of overactive bladder reported at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar from January 2018 to December 2019. This comparative study was done by giving Mirabegron to first five patients and next five patients were given darifenacin up to 120 patients. The drug treatment with once daily administration of 25 mg mirabegron and 7.5 mg of darifenacin was given for a total of 12 weeks. The signs and symptoms were noted at the beginning of the therapy and then follow up was done at 4, 8, 10 and 12 weeks.Results: Total 54 out of 60 patients (90%) on miragaberon and 59 of 60 patients (98.33%) on darifenacin were relieved of symptom of increased frequency of micturition. 53 of 60 pateints (88.33%) on miragaberon and 59 of 60 patients (98.33%) on darifenacin were relieved of symptom of decreased average voiding volume. 28 of 60 pateints (46.67 %) on miragaberon showed nocturia as compared to 25 of 60 patients (41.67%) on darifenacin.Conclusions: It has been concluded that both mirabegron as well as darifenacin are highly efficacious newer treatment options for the management of OAB. Our study found Darifenacin to be relatively more efficacious in the treatment of OAB at a lesser dose and statistically significant differences were observed between the two drugs. 

scholarly journals A prospective study of clinical presentation, management, and post-operative complications of benign parotid swellings

2019 ◽  
Vol 6 (7) ◽  
pp. 2318 ◽  
Author(s):  
Hareesh G. S. R. ◽  
Prabhakar Naidu Pulipati
Keyword(s):  
Pleomorphic Adenoma ◽  
Late Presentation ◽  
Common Benign Tumor ◽  
Operative Complications ◽  
Benign Tumours ◽  
Parotid Tumours ◽  
Operative Findings ◽  
A Prospective Study ◽  
Post Operative Complications

Background: The incidence of parotid tumours is between 1-3/100000 per year, most of them are benign and 80% benign tumours are pleomorphic adenoma. Their management is more troublesome because of their late presentation, poor economic condition and lack of awareness of health.Methods: This is a prospective observational study carried out from August 2016 to march 2018 in the Department of General Surgery, S.V.R.R.G.H., Tirupati. Detailed pre-operative workup done operative findings and post-operative complications were noted and biopsy reports analyzed.Results: Total 30 patients were included in the study of which 28 were pleomorphic adenoma and 2 were Warthin’s tumor. Post-operative complications and histopathology were studied and analyzed.Conclusions: Pleomorphic adenoma was most common benign tumor. Conservative superficial parotidectomy was the common surgical procedure done. Most common complication was temporary facial nerve palsy. No recurrence was seen in 6 months follow up.

scholarly journals Role of Computed Tomography Scan in the Assessment of Subacute Intestinal Obstruction at Bhuj, Kutch: A Prospective Study

2020 ◽  
Vol 8 (1) ◽  
pp. 40-43
Author(s):  
Ashvin Pansuriya
Keyword(s):  
Intestinal Obstruction ◽  
Ct Scan ◽  
Mechanical Obstruction ◽  
Contrast Administration ◽  
Erect Posture ◽  
Ileal Stricture ◽  
Subacute Intestinal Obstruction ◽  
A Prospective Study ◽  
Tomography Scan

Background: Bowel obstruction occurs when the normal flow of intraluminal contents is interrupted. Obstruction can be functional or due to  a mechanical obstruction. Now a day’s CT is considered to be the most efficacious imaging technique for determining the cause of intestinal obstruction. However, the indications for the use of CT in patients with Sub-Acute Intestinal Obstruction (SAIO) have not been fully defined. Objectives of the present study are to study the role of CT in Diagnosis of patients with suspected subacute intestinal obstruction (SAIO), to find out site & cause of obstruction and to diagnose complications of obstruction. Subjects and Methods: This study was conducted at Department of Radiodiagnosis, Gujarat Adani institute of Medcial Science, Bhuj, Kutch, Gujarat. Total number of 22 patients with SAIO having equivocal findings on USG was included in this study. Detailed clinical evaluation of the patients was done. Plain x-ray of abdomen in erect posture & abdominopelvic ultrasound were performed before CT scan. CT scans were performed on a GE lightspeed VCT 64 slice scanner and acquired in precontrast & portovenous phase at 60sec after i.v. contrast administration. Results:  Age of the patients in the study range between 14 to   76 years. Out of 22 were 12 male & 10 female patients. On CT scan all 22 patients were found to have obstruction with 19 patients having mechanical obstruction & 3 patients having pseudo obstruction secondary to appendicitis, jejunal perforation. Most common cause of SAIO was ileal stricture 38% followed by intussusceptions 23%. Conclusion: CT is not only useful in distinguishing mechanical obstruction from paralytic ileus but also it often establishes the cause of obstruction & presence of complications like strangulation & perforation.

scholarly journals Abdominal Cocoon: An Unusual Cause of Intestinal Obstruction

2017 ◽  
Vol 5 (1) ◽  
pp. 49-52
Author(s):  
Tapesh Kumar Paul ◽  
Russel Ahmed Khan Lodi ◽  
Shayda Ali ◽  
Mohammad Arman Zahed Basunia ◽  
Hasan Md Abdur Rouf
Keyword(s):  
Small Intestine ◽  
Intestinal Obstruction ◽  
Rare Condition ◽  
Complete Recovery ◽  
Clinical Suspicion ◽  
Unknown Etiology ◽  
Imaging Findings ◽  
Abdominal Cocoon ◽  
Small Intestinal ◽  
Encapsulating Peritonitis

Abdominal cocoon, the idiopathic form of sclerosing encapsulating peritonitis, is a rare condition of unknown etiology that results in an intestinal obstruction due to total or partial encapsulation of the small bowel by a fibrocollagenous membrane. The early clinical features are nonspecific, are often not recognized and it is difficult to make a definite pre-operative diagnosis. Clinical suspicion may be generated by the recurrent episodes of small intestinal obstruction combined with relevant imaging findings and lack of other plausible etiologies. Surgery is important in the management of this disease. Careful dissection and excision of the thick sac with the release of the small intestine leads to complete recovery in the vast majority of cases. Here a case of abdominal cocoon in a 45 years old male is presented due to its rarity and difficulty in preoperative diagnosis.Delta Med Col J. Jan 2017 5(1): 49-52

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