Abdominal Cocoon With Intestinal Perforation: A Case Report

Introduction: Abdominal cocoon is a very rare abdominal disease. Abdominal cocoon mainly leads to intestinal obstruction, and abdominal cocoon with gastrointestinal perforation is rare.Case Presentation: We report a 63-year-old man who was admitted to our hospital with “persistent lower abdominal pain for one day”. Abdominal CT examination revealed a small amount of free gas in the abdominal cavity, ascites, and gastrointestinal perforation. An emergency operation was performed. During the operation, the end of the right lower abdominal ileum was found to be conglutinated and twisted into a mass, a local intestinal dilatation, and obstruction, local intestinal wall was black and gangrene, and fecal effusion flowed out. The adhesions were carefully separated, and the necrotic small intestine was removed. The operation process went smoothly, and the patient recovered well after the operation.Conclusion: The cases of intestinal perforation caused by the abdominal cocoon are very rare. In clinical work, when we encounter patients with gastrointestinal perforation, we need to carefully ask the history. When the patients had no digestive system diseases in the past, we need to consider the possibility of the abdominal cocoon with perforation.

Primary Abdominal Cocoon with Right Intra-Abdominal Cryptorchidism: A Case Report

Background: Primary abdominal cocoon is a special peritoneal disease and easily cause misdiagnosis and mistreatment. Few cases have been reported primary abdominal cocoon with intra-abdominal cryptorchidism in the literature.Case presentation: We admitted one case of a 41-year-old male patient with primary abdominal cocoon and right intra-abdominal cryptorchidism. The main symptom of this patient was intermittent abdominal pain for more than one month, preoperative CT results showed that part of the small intestine folded into a mass, which was suspected of abdominal cocoon. Part of the small intestine was wrapped by fibrous membrane and the right testicle were observed in the abdominal cavity during the operation. Intestinal adhesion release and right cryptorchidectomy were performed successfully. Pathological results revealed that the membranous material was fibrous connective tissue with chronic inflammatory cell infiltration and no spermatogenic cells and sperm were observed in the seminiferous tubules of the testicular tissue. Conclusion: This article reports one case of primary abdominal cocoon with right intra-abdominal cryptorchidism. Primary abdominal cocoon lacks specific clinical manifestations, part of patients may have cryptorchidism and the diagnosis is difficult. We should improve the understanding of primary abdominal cocoon to better save the life of patient.