Primary abdominal cocoon with cryptorchidism: a case report
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CASE REPORT
Open Access
Primary abdominal cocoon with cryptorchidism: a case report Wei-Jie Song1,2, Xin-Yi Liu3, Galal Abdullah Ali Saad4, Aawrish Khan4, Kai-Yan Yang4, Yi Zhang4, Jian-Ye Liu1,2 and Le-Ye He1,2*
Abstract Background: We report a rare case of primary abdominal cocoon with bilateral cryptorchidism. Case presentation: The patient had a history of laparoscopic surgery for bilateral cryptorchidism 6 years earlier. He was admitted to the hospital again due to intestinal obstruction. Surgery was performed on the patient after the failure of conservative treatment. The patient was diagnosed with primary abdominal cocoon. Instead of the greater omentum, many cocoon-like tissues surrounding the bowel were seen during operation. Abdominal surgery can increase the risk of intestinal adhesion, which is one of the main causes of intestinal obstruction, especially in patients with abdominal cocoon. We hypothesize that the surgery 6 years earlier to address transabdominal bilateral cryptorchidism accelerated the patient’s intestinal obstruction. Conclusion: This case implies that it is important for urologists to evaluate whether their patients exhibit abdominal cocoon before cryptorchidism surgery, to choose better surgical methods and reduce the risks of poor prognosis. Keywords: Cryptorchidism, Abdominal cocoon syndrome, Cryptorchid surgery, Prognosis, Case report
Background Abdominal cocoon syndrome (ACS), a rare disease of the abdominal organs, is characterized by a dense, pale abnormal fibrous collagen membrane wrapping part or all of the intestine like a cocoon, usually known as primary or secondary abdominal cocoon, as distinguished later in this report. Cryptorchidism is a congenital testicular malformation that can be divided into unilateral or bilateral cryptorchidism, appearing as a missing testicle in the affected lateral scrotum [1]. Common symptoms of ACS include abdominal pain, bloating, vomiting, and abdominal masses. It has been reported that tuberculosis may be related to the formation of abdominal * Correspondence: [email protected] 1 Department of Urology, Central South University, The Third Xiangya Hospital, No. 138 Tongzipo Road, Changsha City 410013, Hunan Province, China 2 Institute of Prostate Disease, Central South University, Changsha, Hunan, China Full list of author information is available at the end of the article
cocoon [2]. However, coexistence of ACS with cryptorchidism is very rare, and to our knowledge, there have been only two case reports of ACS with unilateral cryptorchidism. The exact causes of this disease are unknown.
Case presentation In this case, a 19-year-old male patient had been diagnosed with bilateral cryptorchidism for bilateral scrotal emptiness 6 years earlier. The left testicle was removed by laparoscopic surgery, and the right testicle was lowered and fixed. The operation was successful. In December 2019, the patient was re-admitted to the hospital, due to abdominal pain accompanied by nausea and vomiting for 3 days. By examination, the abdomen was swol
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