Encapsulating Peritoneal Sclerosis: A Rare Cause of Acute and Recurrent Abdominal Pain; A Case Report of Abdominal Cocoon Syndrome

Encapsulating peritoneal sclerosis (EPS), also known as abdominal cocoon syndrome, is a rare condition thatmay present with abdominal pain or intestinal obstruction due to the encasement of bowel loops within afibrocollagenous membrane. We report the case of a 27-year-old woman who presented with severe generalizedabdominal pain, nausea, and vomiting that did not respond to conservative treatment. Physical examinationrevealed right lower quadrant tenderness, and subsequent exploratory laparotomy demonstrated abdominalcocoon syndrome associated with an appendiceal mucocele. This rare entity typically manifests as recurrentabdominal pain and obstructive symptoms, and while conservative therapy may provide transient relief, itoften delays diagnosis. Surgical excision of the fibrous membrane with adhesionolysis remains the definitivetreatment in severe cases. Abdominal cocoon syndrome should be considered in the differential diagnosis ofunexplained abdominal pain and obstruction, as diagnosis is frequently established only intraoperatively.