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Abdominal Cocoon: Preoperative Diagnostic Clues from Radiologic Imaging with Pathologic Correlation

Jin Hur1, Ki Whang Kim2, Mi-Suk Park1 and Jeong-Sik Yu1

1 Department of Diagnostic Radiology, Yonsei University College of Medicine, Research Institute of Radiological Science, Yongdong Severance Hospital #146-92, Dogok-Dong, Kangnam-Gu, Seoul 135-270, South Korea.
2 Department of Diagnostic Radiology, Yonsei University College of Medicine, Research Institute of Radiological Science, 134 Shinchon-dong, Seodaemoon-Ku, Seoul 120-752, South Korea.



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  		Fig. 1A. —34-year-old women with abdominal cocoon. Abdominal sonogram shows large echogenic mass associated with small amount of ascites in left lower abdomen.

 


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  		Fig. 1B. —34-year-old women with abdominal cocoon. CT scan of lower abdomen shows clustered gas-containing small-bowel loops with thick membranelike sac (arrowheads) and dilated proximal small bowel with air–fluid levels due to intestinal obstruction.

 


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  		Fig. 1C. —34-year-old women with abdominal cocoon. Barium follow-through radiograph shows ileal loops (arrows) bunched and confined in lower abdomen and pelvis, giving rise to extrinsic mass effect on encased small-bowel loops.

 


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  		Fig. 2A. —47-year-old man with abdominal cocoon. CT scan of mid abdomen shows cluster of jejunal loops sacculated in thin, delicate, membranelike sac (arrows) that occupies right mid abdomen.

 


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  		Fig. 2B. —47-year-old man with abdominal cocoon. Barium follow-through radiograph reveals fixed cluster of jejunal loops (arrowheads) that maintains constant position in right middle abdomen.

 

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