Location
Moultrie, GA
Start Date
17-4-2026 12:00 PM
End Date
17-4-2026 1:00 PM
Description
Small bowel obstruction (SBO) is a common surgical emergency that is the result of an incomplete or total blockage of the intestinal lumen, resulting in proximal dilation with contents and gas. Untreated SBO may result in vascular compromise leading to tissue ischemia, necrosis, or perforation. The most common causes of SBO include adhesions, hernias, malignancy and chronic inflammatory conditions. SBO can be further classified into patterns of single adhesive bands or matted adhesions. Work-up of SBO begins with CT imaging to visualize the extent of bowel obstruction followed by conservative management with bowel rest, IV fluids, and NG tube decompression. In the presence of unrelenting obstruction and evidence of ischemia, high risk cases commonly require surgical intervention via exploratory laparotomy. Amongst the most unique presentations of SBO is that of the Abdominal Cocoon, pathologically known as Sclerosing Encapsulating Peritonitis, resulting in the build-up of interwoven fibrous tissue. Literature suggests that the development of an abdominal cocoon is either idiopathic in nature or secondary to chronic peritoneal irritation. Here, we present the case of a 72 year old male with a past medical history significant for alcohol use disorder, cirrhosis, and chronic pancreatitis who presented to the emergency department with complaints of abdominal pain and acute urinary retention. Following a trial of conservative management, the patient underwent exploratory laparotomy revealing extensive adhesion structure encapsulating an intensely dilated small bowel, with multiple pockets of white, milk, and cloudy fluid requiring extensive adhesiolysis. Incidental findings included the presence of a wide-based Meckel’s diverticulum that was resected and later confirmed on pathology report. Post-operatively, the patient’s complaint of acute abdominal pain was resolved, with passage of flatus and bowel movements shortly thereafter. This case highlights the importance of acknowledging less common etiologies of SBO in the context of patients with history significant for chronic inflammatory states when considering more aggressive management following conservative treatment.
Embargo Period
5-27-2026
Included in
Small Bowel Obstruction in the Setting of Sclerosing Encapsulating Peritonitis: A Case Report
Moultrie, GA
Small bowel obstruction (SBO) is a common surgical emergency that is the result of an incomplete or total blockage of the intestinal lumen, resulting in proximal dilation with contents and gas. Untreated SBO may result in vascular compromise leading to tissue ischemia, necrosis, or perforation. The most common causes of SBO include adhesions, hernias, malignancy and chronic inflammatory conditions. SBO can be further classified into patterns of single adhesive bands or matted adhesions. Work-up of SBO begins with CT imaging to visualize the extent of bowel obstruction followed by conservative management with bowel rest, IV fluids, and NG tube decompression. In the presence of unrelenting obstruction and evidence of ischemia, high risk cases commonly require surgical intervention via exploratory laparotomy. Amongst the most unique presentations of SBO is that of the Abdominal Cocoon, pathologically known as Sclerosing Encapsulating Peritonitis, resulting in the build-up of interwoven fibrous tissue. Literature suggests that the development of an abdominal cocoon is either idiopathic in nature or secondary to chronic peritoneal irritation. Here, we present the case of a 72 year old male with a past medical history significant for alcohol use disorder, cirrhosis, and chronic pancreatitis who presented to the emergency department with complaints of abdominal pain and acute urinary retention. Following a trial of conservative management, the patient underwent exploratory laparotomy revealing extensive adhesion structure encapsulating an intensely dilated small bowel, with multiple pockets of white, milk, and cloudy fluid requiring extensive adhesiolysis. Incidental findings included the presence of a wide-based Meckel’s diverticulum that was resected and later confirmed on pathology report. Post-operatively, the patient’s complaint of acute abdominal pain was resolved, with passage of flatus and bowel movements shortly thereafter. This case highlights the importance of acknowledging less common etiologies of SBO in the context of patients with history significant for chronic inflammatory states when considering more aggressive management following conservative treatment.