# Research progress on abdominal cocoon syndrome

**Authors:** Tao Chen, Aixia Kuang, Jinjian Xiang

PMC · DOI: 10.3389/fmed.2026.1767029 · Frontiers in Medicine · 2026-02-05

## TL;DR

This review summarizes what is known about Abdominal Cocoon Syndrome, a rare condition causing intestinal blockage, and highlights recent insights into its diagnosis and treatment.

## Contribution

The paper provides a comprehensive review of ACS, emphasizing recent findings on its association with tuberculous peritonitis and advances in imaging and surgical techniques.

## Key findings

- ACS is often linked to tuberculous peritonitis, requiring careful differential diagnosis.
- Improved imaging techniques have enhanced preoperative detection of ACS.
- Surgical intervention remains the main treatment, with a focus on minimizing complications.

## Abstract

Abdominal Cocoon Syndrome (ACS) is an uncommon medical condition defined by the encasement of the small intestine within a robust fibrocollagenous membrane, frequently resulting in intestinal obstruction. The clinical presentation of this syndrome is varied, which complicates its diagnosis due to both its atypical symptoms and infrequency. This review offers an extensive summary of the existing knowledge regarding ACS, concentrating on its causes, clinical manifestations, diagnostic imaging, pathological features, treatment modalities, and prognostic implications. Recent case studies and research have clarified the correlation between ACS and conditions such as tuberculous peritonitis, underscoring the necessity for differential diagnosis. Enhancements in imaging methodologies have facilitated improved preoperative identification, while surgical treatment continues to be the primary approach, with particular attention given to essential surgical techniques and the management of intraoperative complications. Through a systematic evaluation of contemporary literature, this review aspires to elevate clinical awareness, enable prompt diagnosis, and encourage tailored treatment strategies aimed at enhancing patient outcomes in cases of ACS.

## Linked entities

- **Diseases:** Abdominal Cocoon Syndrome (MONDO:1010131), tuberculous peritonitis (MONDO:0006000)

## Full-text entities

- **Genes:** TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, TGFB1 (transforming growth factor beta 1) [NCBI Gene 7040] {aka CAEND1, CED, DPD1, IBDIMDE, LAP, TGF-beta1}
- **Diseases:** immune-mediated peritoneal diseases (MESH:D010532), situs inversus totalis (MESH:D012857), systemic autoimmune disorders (MESH:D020274), fibrosis (MESH:D005355), congenital anomalies (MESH:D000013), bowel injury (MESH:D012778), chronic inflammatory disorder (MESH:D020277), trauma (MESH:D014947), chronic inflammation (MESH:D007249), pelvic abscess (MESH:D000038), swelling (MESH:D004487), Tuberculous peritonitis (MESH:D014395), blood loss (MESH:D016063), carcinomatosis (MESH:D002277), SBO (MESH:D007409), seminoma (MESH:D018239), abdominal compartment syndrome (MESH:D059325), abdominal pain (MESH:D015746), Encapsulating peritoneal sclerosis (MESH:D056627), ischemic (MESH:D002545), rupture (MESH:D012421), neoplasms (MESH:D009369), postoperative pain (MESH:D010149), calcifications (MESH:D002114), irritation (MESH:D001523), confusion (MESH:D003221), nausea (MESH:D009325), autoimmune disorders (MESH:D001327), Hemorrhage (MESH:D006470), sclerosis (MESH:D012598), emesis (MESH:D014839), AC (MESH:D055577), ACS (OMIM:613630), SLE (MESH:D008180), obstruction (MESH:D000402), IgG4 (MESH:D000077733), sclerosing mesenteritis (MESH:D015436), bowel ischemia (MESH:D007511), intra-abdominal neoplasms (MESH:D000008), malabsorption (MESH:D008286), malnutrition (MESH:D044342), adhesions (MESH:D000267), obliterative phlebitis (MESH:D010689), ascites (MESH:D001201), perforated appendicitis (MESH:D001064), gastrointestinal ailments (MESH:D005767), postoperative complications (MESH:D011183), PD (MESH:D010538), hernias (MESH:D006547), bowel dilation (MESH:D002311), infection (MESH:D007239), TB (MESH:D014376), constipation (MESH:D003248), hypersensitivity (MESH:D004342), stoma dysfunction (MESH:D006331), acute intestinal obstruction (MESH:D007415), perforation (MESH:D057112), congenital or developmental anomalies (MESH:C566440), abdominal discomfort (MESH:D000007), nausea, vomiting (MESH:D020250)
- **Chemicals:** PD (-), glucose (MESH:D005947)
- **Species:** Homo sapiens (human, species) [taxon 9606], Mycobacterium tuberculosis (species) [taxon 1773]

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12916398/full.md

## References

84 references — full list in the complete paper: https://tomesphere.com/paper/PMC12916398/full.md

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Source: https://tomesphere.com/paper/PMC12916398