Conundrum of the cocoon: report of a case and review of the literature.

Idiopathic, sclerosing, encapsulating peritonitis, or abdominal cocoon, is a rare cause of bowel obstruction in the elderly. A 65-year-old male patient presented with acute bowel obstruction caused by torsion of the encapsulated small bowel. He was treated successfully with subtotal excision of the fibrocollagenous membrane and small bowel resection. Despite anecdotal reports of a preoperative diagnosis, in the majority of cases, sclerosing, encapsulating peritonitis is a fortuitous finding. A better awareness of this condition may facilitate preoperative diagnosis.