Idiopathic cocoon syndrome presenting as small bowel obstruction with asymptomatic postoperative intra-abdominal collection: a case report

Abdominal cocoon syndrome (ACS) is a rare cause of small bowel obstruction (SBO). Its nonspecific presentation frequently mimics more common obstructive pathologies, delaying diagnosis. A 56-year-old male presented with abdominal pain, obstipation, and vomiting. CT showed clustered ileal loops. Exploratory laparotomy revealed a thick fibrocollagenous peritoneal membrane encapsulating ischemic bowel loops. Resection of non-viable bowel and enteroenterostomy were performed. Postoperative recovery was complicated with an asymptomatic intra-abdominal collection managed with vacuum-assisted dressing. ACS poses diagnostic and therapeutic challenges. Early recognition and surgical intervention are essential to avoid complications. Clinician awareness is crucial for timely diagnosis and management.